ORAL ANSWERS TO QUESTIONS

DEFENCE

The Secretary of State was asked—

Armed Forces Pay

Diana Johnson: What recent assessment he has made of the effects of the 2012 Budget on the pay of all ranks of armed forces personnel.

Philip Hammond: The Chancellor announced extensions to public sector pay restraint in the autumn statement 2011. That will impact on armed forces pay. However, my right hon. Friend announced no further changes in relation to pay in the 2012 Budget, but he did announce the doubling of council tax relief for personnel on operations; the doubling of the families welfare fund to support the families of those deployed; and an additional £100 million of spending to improve accommodation for service personnel and their families. In addition, the lower-paid members of the armed forces are benefiting from the changes to taxation announced in the Budget.

Diana Johnson: Before the 2010 election, in full knowledge of the deficit, Hull Liberal Democrats promised to “raise the pay of our lowest-paid soldiers by as much as £6,000”. Lib Dems now back the pay freeze and the 20,000 redundancies while expecting our troops to sort out the Olympic shambles. Why should our armed forces trust Liberal Democrat promises ever again?

Philip Hammond: The hon. Lady supported the Government who got us into the deficit that this Government are currently digging our way out of. We are setting out plans for sustainable, affordable armed forces who will be properly equipped for the task we ask them to do in future. They understand that.

Mark Lancaster: Part of the remuneration package for reservists is the option for them to earn a bounty if they are deemed to be efficient. Territorial Army regulations allow the linking of a compulsion to train on certain days with the award of that bounty. Although that is not currently done, are there any plans to do it in future?

Philip Hammond: As my hon. Friend knows, we are committed to publishing a consultation document in the autumn that will look at employer engagement and terms and conditions for reservists. We will set out clearly our proposals for the new deal for reserves under the new arrangements I announced last week.

Jim Murphy: There is all-party concern about forces’ pay during the Olympic games. The Secretary of State is right that there is no exact comparison with other workers, but the country has noticed that London bus and train drivers are getting Olympic bonus payments and that our forces are not. What contact has he had with G4S about it paying bonuses to troops who are called up at the last minute? I do not begrudge the transport workers their bonus, but just because troops rightly cannot go on strike, they should not be ignored by the Government.

Philip Hammond: Clearly the union got to the right hon. Gentleman and made sure he included that last bit. We are determined to ensure that the welfare of our troops who are engaged in the Olympic project is properly looked after while they are deployed on that operation and that they are properly recognised. I am in discussion with senior members of the armed forces about how best to do that.
	The Government do not have a direct contractual relationship with G4S—the London Organising Committee of the Olympic Games and Paralympic Games holds that relationship—but I can assure the right hon. Gentleman that whatever resources we need to ensure we offer an appropriate package to our armed forces will be made available.

David Davies: Does my right hon. Friend share my concern that battalions made up largely of British personnel, such as the Royal Welsh, are now facing the axe, whereas battalions made up largely of non-British personnel, such as the Gurkhas, are not?

Philip Hammond: This strays slightly wide of the original question. I explained the week before last, I believe, the reason why the decision was taken not to look at removing a Gurkha Rifles battalion—the arrangements we have with the Sultanate of Brunei for the rotation of battalions would have broken down and been inoperable had we removed one of the two battalions.

Middle East

Robert Halfon: What recent assessment he has made of the defence situation in the middle east; and if he will make a statement.

Nick Harvey: Demands for greater political, social and economic participation continue in the middle east and north Africa. The situation in Syria continues to deteriorate and we are supporting efforts to deliver a political solution to the conflict. The UK also remains concerned over Iran’s nuclear programme and continues to work with other countries to achieve a diplomatic solution to Iran’s nuclear ambitions. On that basis, we assess that the regional security situation will remain fragile.

Robert Halfon: As the security situation in the Sinai peninsula deteriorates, weapons bound for Gaza’s terrorists are being freely smuggled, and two cross-border terror attacks have left nine Israelis dead. What assessment have the Government made of the Egyptian authorities’ efforts to tackle the security threat emanating from this no man’s land?

Nick Harvey: The Government remain concerned about the security situation in Sinai and we regularly raise it with the Egyptian authorities. There continue to be credible reports of significant quantities of weapons—particularly rockets—being smuggled into Gaza. The UK recognises that Israel has legitimate security concerns and that the people of Gaza are suffering at the moment, which does not serve Israel’s long-term security interests.

Jeremy Corbyn: The Minister will be aware that the last nuclear non-proliferation review conference agreed on a strategy of a nuclear weapons-free middle east and that, because Israel is not a signatory to the non-proliferation treaty, a special conference, hosted by the Finnish Government, will be held in Helsinki at the end of this year. Will he assure the House that the British Government remain fully behind the process, will be represented at that conference and will do their best to ensure that both Israel and Iran are also present, to bring about a nuclear weapons-free region?

Nick Harvey: We continue to support that initiative, and I assure the hon. Gentleman that we will be represented at that conference. We would like it to make progress, but we do not underestimate the inherent challenge.

Menzies Campbell: My hon. Friend has already indicated by his answers that there is an inextricable link between the military and political situations in the middle east. It is also the case that there is still consideration—the possibility—of a strike by Israel against Iran. Have my hon. Friend and the Government made any assessment of the political fallout of such a strike?

Nick Harvey: The Government remain committed to finding a diplomatic solution to the problem of Iran’s nuclear ambitions, and we continue to work with international allies and others around the world to try to bring it about. We stand ready to help the international community in the event of any general security deterioration in the region, but it is important above all else that we find an international solution to what is a very tricky problem.

Russell Brown: Within the last 24 hours, the International Committee of the Red Cross has stated that the situation in Syria has now developed into a civil war. What are the implications for us of such a statement, and has the Secretary of State spoken with his US or any other NATO counterparts about what practical measures need to be taken to alleviate the pain and suffering of the Syrian people?

Nick Harvey: The Foreign Office is in constant dialogue with international communities and our allies about the grave situation in Syria. Nobody underestimates the
	difficulty that will be involved in trying to secure any international consensus in favour of action there. The recent events that we have seen are deeply shocking. The Government want to see an end to violence and an orderly transition to a more representative form of government, but the efforts being made so far are certainly hitting a lot of obstacles.

Joint Strike Fighter

Elizabeth Truss: What progress his Department has made on selecting the future base for the joint strike fighter.

Nick Harvey: Although an initial decision had been made by the previous Government on the basing for the joint strike fighter, it is being reviewed in the light of the strategic defence and security review, as part of the work on the footprint strategy for the defence estate. The military requirement for the joint strike fighter has gone forward to the Defence Infrastructure Organisation, which is leading the work to deliver a defence estate of a sustainable size and shape, and one that delivers the most cost-effective approach to Future Force 2020 basing.

Elizabeth Truss: Three weeks ago, the Secretary of State for Defence is reported to have said that RAF Marham would be the logical base for the joint strike fighter. Can the Minister tell me when a decision on basing will be made to help to secure the base’s long-term future, as well as boost confidence for local businesses in west Norfolk?

Nick Harvey: This Thursday, the Defence Secretary will take delivery of the first of our joint strike fighter aircraft. A decision will be made on where it will be based in good time for the introduction of the strike fighter into service. Detailed work is taking place at the moment to look at the basing requirements, and we will make a decision as soon as is practically possible.

Angus Robertson: The Minister will no doubt recall that the Ministry of Defence has already concluded that the optimal base for the next generation of fast jets is RAF Lossiemouth, but I am sure that he will also appreciate that, in relation to RAF Lossiemouth, the thoughts of everyone at the moment will be with the personnel and with the families of the crew members who died on board the two Tornadoes that were lost. Will he take this opportunity to update the House on the recovery operation, and on the medical condition of the fourth crewman, who was recovered?

Nick Harvey: The investigation into what went wrong is continuing, and I must be careful not to say anything that could prejudice it. Our thoughts are with the community and, in particular, with the relatives of those who perished. As soon as we can, we will make it clear to everyone what contributed to that disastrous incident.
	On the future of Lossiemouth, the hon. Gentleman will be aware that since that announcement, it has been announced that Typhoon is moving into Lossiemouth. With the best will in the world, it would not be practical to have both fleets situated at one base.

Alison Seabeck: The Minister talked about the bases for the joint strike fighter. The Government have already carried out two U-turns on the joint strike fighter programme and sold the Harrier fleet to the USA. Given that the USA is now in the throes of major budget problems and, if the story in The Sun today is to be believed, might well pull the plug on the whole programme, will the Minister reconfirm the confidence expressed by the Secretary of State a few weeks ago not only in the joint strike fighter programme but in the carrier programme? Will he also confirm that there will be no further budget increases as a result of what is happening in the USA?

Nick Harvey: I am sure that the hon. Lady does not believe everything she reads in The Sun, or indeed in any other newspaper. There are stories almost every week about the alleged state of that programme in the US. On Wednesday this week, the Secretary of State will be visiting the US Marine Corps to see the short take-off and vertical landing—STOVL—version of the joint strike fighter flying. It has already done 1,000 hours of flying time with the US Marine Corps, and we have every confidence that it will come into service as planned.

Army Recruiting Policy

Patrick Mercer: What plans he has for Army recruiting policy in the next five years; and if he will make a statement.

Andrew Robathan: Recruiting remains one of the Army’s highest priorities. Given that it is an organisation that promotes from within, there is an enduring need to ensure that the Army has the capacity to take on an appropriate number of new recruits. Our recruiting targets are already reflecting those required for a regular Army of 82,000, with current planned annual recruitment figures of approximately 600 officers and 7,400 soldiers.

Patrick Mercer: I am interested in the Minister’s reply, especially in the light of the Secretary of State’s statement on recruitment the week before last. The trouble is that recruiting takes a long time, and if we need troops to be instantly available—as we have done for the Olympic games—we surely need to rethink the cuts to major units, particularly the five infantry battalions.

Andrew Robathan: I know that my hon. Friend was responsible for recruiting in his last job in the Army; he was director of Army recruiting, and I pay tribute to him for that. He will know that making these cuts to the Army is not something that we would have wished to do; they were forced upon us by the appalling financial position that was left behind—

Kevan Jones: Groundhog day!

Andrew Robathan: Groundhog day it may be, but it is also true. I appreciate what my hon. Friend the Member for Newark (Patrick Mercer) says about recruiting taking a long time, and I know that my right hon. Friend the Secretary of State understands the difficulty of raising extra troops at short notice.

Barry Sheerman: Some of the brightest and bravest soldiers have traditionally been recruited in Yorkshire, but the people of Yorkshire are pretty savvy, and they know that the critical mass of our armed forces is such that joining up has a declining attraction for young men and women in the present situation.

Andrew Robathan: I pay tribute to the soldiers from Yorkshire. They join not only the Yorkshire regiments but the Coldstream Guards, with whom I served, and other corps throughout the British Army. Joining the Army remains an attractive option, and I would recommend it to anyone. It is sad that fewer people are joining at the moment.

Bob Russell: I am sure that the Minister will be pleased that the Secretary of State gave an assurance to the Defence Select Committee last week that the decisions to cut the Army would be revisited in 2015. Alongside welcoming that, will the Minister give me an assurance that recruiting policy will look again at the Pay As You Dine arrangements?

Andrew Robathan: I am not entirely sure that my right hon. Friend did give that assurance, but no doubt the hon. Gentleman can discuss that with him. The decisions were made by the Army itself—by generals looking carefully at future recruiting patterns—and I am sure that they will keep the matter under constant review as well.
	I understand that Pay As You Dine was introduced at the request of members of the armed forces under the last Administration. Although not universally popular, it does mean that people pay less for food that they often did not eat under the old system.

Madeleine Moon: Wales has an excellent reputation for recruiting into the Army, and the loss of the 2nd Battalion The Royal Welsh has come as a huge blow there. What steps will the Minister take to ensure that Welsh men and women who wish to join Welsh regiments will continue to do so following the loss of the 2nd Battalion?

Andrew Robathan: As I have said, I think that everyone regrets the loss of the 2nd Battalion The Royal Regiment of Wales, but Welsh men and women do join the armed forces. Welsh men join the Welsh Guards; they join all the corps, and so forth. I spent 15 years in the Army until I was kicked out, and I think that it still provides a very attractive career for any young man or woman.

Farnborough Air Show

Jason McCartney: What steps his Department has taken to promote defence exports at the Farnborough air show.

Phillip Lee: What steps his Department has taken to promote defence exports at the Farnborough air show.

Gerald Howarth: The Farnborough international air show, which takes place in my constituency, was opened last Monday by my right hon. Friend the Prime
	Minister, who emphasised the high importance that the Government attach to supporting defence and security exports. My right hon. Friend the Secretary of State for Defence attended with his ministerial team, and we were extremely well supported throughout by the team from the UK Trade and Investment Defence and Security Organisation. RAF air and ground crews, accompanied by Italian air force personnel, were on hand to provide briefings on the outstanding role played by the Typhoon on operations over Libya last year. In addition, 150 air cadets were out in force helping the show organisers.

Jason McCartney: I visited the Farnborough air show myself last week and was able to see the best of the British aerospace industry, which employs 100,000 people, is worth £20 billion, and holds a 17% share of the global market. Will the Minister join me in recognising the importance of the role played by small and medium-sized enterprises in the supply chain, particularly those in my constituency which are driving growth and employing apprentices?

Gerald Howarth: I am grateful to my hon. Friend for setting out so clearly the merits of the Farnborough air show. He is absolutely right: SMEs play a hugely important part. It is not just about the big boys. Without the SMEs, which are a repository of a huge amount of highly specialised technical knowledge, we would not have the industries that we do have. I am pleased to say that orders worth $72,000 million were signed as a result of last week’s show.

Phillip Lee: I too had the privilege of attending the air show last week, in my capacity as vice-chairman of the Parliamentary Space Committee. The UK’s space industry has grown by 10% year on year for most of the last decade. Will the Minister tell me how the Ministry of Defence is supporting UK business in exporting in the defence sector?

Gerald Howarth: I am pleased to say that the space industry is making a hugely important contribution in the United Kingdom. We have a number of very well-qualified companies. Two names that spring to mind are EADS Astrium and Surrey Satellite Technology, both of which are making huge contributions. I must tell my hon. Friend, however, that this is quite sensitive territory, and I cannot go into too much detail.

Denis MacShane: We are still exporting arms to Bahrain, where the death toll mounts, the numbers in prison grow and the torture continues. I am curious to know whether the Minister has any moral qualms about that.

Gerald Howarth: As the right hon. Gentleman knows perfectly well from his experience in the Foreign Office, we have one of the most stringent arms export control arrangements in the world, and we look very carefully at these matters. I should add that Bahrain has been an extremely important friend and ally to both the United Kingdom and the United States.

Ian Davidson: Many Scottish firms get assistance from UK Trade and Investment and benefit from the fact that the British
	forces use Scottish equipment. Are Scottish firms likely to be helped or hindered by any breakaway of Scotland from the rest of the United Kingdom?

Gerald Howarth: rose—

Mr Speaker: Order. Please will the Minister answer that question with reference purely, and very narrowly and briefly, to the Farnborough air show?

Gerald Howarth: First, let me say that the Typhoon air display was given by a Scot—Scott Loughran. He gave an absolutely stunning display of the Typhoon. The UKTI Defence and Security Organisation represents the whole United Kingdom, and it does a great job for Scotland. If we were to bust up the UK, that would be bad news for Scotland, bad news for the UK and bad news for all businesses in this country.

James Arbuthnot: The fact that last week some 16 Ministers attended the Farnborough air show, all of whom showed a great degree of knowledge and interest, and the fact that the Prime Minister opened it with an outstanding speech, went down extremely well with the defence industry. Is my hon. Friend able to say whether exactly the same will happen in two years’ time?

Gerald Howarth: I am grateful to my right hon. Friend, and constituency neighbour, for pointing out that—as the trade association, the ADS, also observed—the event had unprecedented support from Ministers, including the Prime Minister and the Foreign Secretary, and from the Opposition as well. The support given to the show has been extremely valuable. I myself had 15 meetings with overseas delegations, and I can tell my right hon. Friend that I fully expect the same to apply in 2014.

Equipment and Support Contracts (SMEs)

David Rutley: What his most recent estimate is of the proportion of defence equipment and support contracts let to small and medium-sized enterprises.

Priti Patel: What his most recent estimate is of the proportion of defence equipment and support contracts let to small and medium-sized enterprises.

Peter Luff: During the financial year 2011-12, approximately 41% of new contracts were awarded to small and medium-sized enterprises. That represented approximately 13% of the value of all new contracts placed in the year. A significant proportion of our other business also reaches SMEs from the prime contractors through the supply chain.

David Rutley: I welcome the recent announcement that 41% of contracts were awarded to SMEs. They are vital not only to our security, but to the economy. What steps is my hon. Friend taking to fulfil their potential abroad as well as at home?

Peter Luff: I am glad to say that I find that SMEs are often particularly energetic in pursuing overseas opportunities. Indeed, many British small defence contractors begin their commercial lives exporting, rather than selling to the domestic market, which is a great tribute to the enterprise they show. UKTI DSO takes enormous steps to help SMEs. It participates in many trade delegations with my hon. Friend the Member for Aldershot (Mr Howarth), the Minister with responsibility for international security strategy. I pay tribute to DSO and to SMEs, which make a great contribution to our economy and to defence.

Priti Patel: There are 3,000 SMEs in the UK defence industry, and they are doing great things for our economy and vital work for our defence sector. What is the MOD doing to make Government business more accessible to these SMEs?

Peter Luff: My hon. Friend might apply for an Adjournment debate on that topic, because it would test your patience, Mr Speaker, if I were to list all the things we are doing to help SMEs, which include producing simplified standard contracts, making SMEs aware of tendering opportunities, and ensuring they are paid quickly. However, I attach the greatest importance to the establishment of the suppliers’ forum for SMEs, which I chair, and which enables us to pursue in detail both the concerns of SMEs and the issues we have in dealing with them. That is a very fruitful discussion, which is leading to a radical simplification of the way in which we do business with SMEs, and in due course it will create many more opportunities for them.

Mr Speaker: I always have patience for orderly answers, but not for speeches masquerading as answers. I know the Minister will readily accept that point.

Kevin Brennan: On defence contracts, will the MOD’s current plans inevitably result in more contracts for companies such as G4S?

Peter Luff: That is not my responsibility. I was talking about defence equipment and support contracts, and as far as I am aware—I stand ready to be corrected—G4S has no role in such contracts.

Jim Shannon: Many SMEs in Northern Ireland are involved merely on the periphery of large MOD contracts. What steps are the Government taking to ensure that there is a fair distribution of defence contracts and fair business opportunities for SMEs in Northern Ireland?

Peter Luff: It is one of the sadnesses of the structure of the UK defence industry that defence industries are relatively few and far between in Northern Ireland. Of course, Thales is the prime example of an excellent company doing first-rate work in Northern Ireland; I visited it earlier this year, seeing for myself just how good that company is, and it makes a huge contribution through the supply chain. The small and medium-sized businesses of Northern Ireland can also contribute to other contracts throughout the United Kingdom, and I am sure they are doing so in a realistic and strong way.

Defence Equipment and Support

Kerry McCarthy: What plans he has for the future of Defence Equipment and Support; and if he will make a statement.

Philip Hammond: I expect to be able to make a written ministerial statement about this issue tomorrow that will give further detail. However, in headline terms, the analysis conducted by the Chief of Defence Matériel on the comparative benefits of changing Defence Equipment and Support into either an Executive non-departmental public body with a strategic partner from the private sector or a Government-owned contractor-operated entity suggests that the strategic case for the GoCo option is stronger. More value-for-money analysis is required to confirm that assessment, and the Ministry of Defence will focus effort over the summer on developing and testing the GoCo option further.

Kerry McCarthy: I thank the Secretary of State for that reply. Was it not the case that the Government were always in favour of privatising Defence Equipment and Support but found it difficult to find the evidence to show that that provided value for money for the taxpayer? Were the other options under active consideration and in development?

Philip Hammond: We have looked at all the options, including what we call “DE and S-plus”: keeping an on-vote solution with enhanced capabilities. At the moment, it is clear that the work being done is pointing in the direction of a Government-owned contractor-operated entity, but I will publish further details tomorrow, and further details still as they become available later in the summer and in the autumn.

Julian Brazier: While welcoming my right hon. Friend’s willingness to be bold in this area, may I suggest to him that one of the key factors to take into account in deciding just how bold to be—the GoCo is the boldest option—will be how many years Mr Gray is willing to stay in the job? I speak as one of his great admirers.

Philip Hammond: We are extremely grateful for the contribution that Bernard Gray is making as Chief of Defence Matériel. He is looking at bold and radical solutions that will allow us to deliver the equipment programme within the budget envelope we have set, and thus ensure that the whole of our programme for the armed forces is sustainable, in marked contrast to what the previous Government managed to deliver.

Employment (Veterans)

Huw Irranca-Davies: What steps his Department is taking to improve the employment opportunities of veterans.

Andrew Robathan: Prior to leaving, all service personnel are entitled to some form of resettlement assistance consisting of time, money and training, according to their length of service. Those who have served for six years or more, and all those medically discharged,
	regardless of how long they served for, are entitled to the full resettlement programme, which includes a three-day career transition workshop, the use of a career consultant, a job-finding service, and retraining time and a retraining grant. Those who have served for four years or more are entitled to employment support in the form of a bespoke job-finding service and career interview.

Huw Irranca-Davies: May I invite the Minister to borrow or even steal an excellent idea from the Labour Front-Bench team—the Labour veterans interview programme, where leading companies guarantee veterans interviews for appropriate vacancies—and include that as part of the official resettlement programme? Will he support the calls to roll that programme out through Jobcentre Plus, as it would be a great boon for our armed services?

Andrew Robathan: Having previously extolled the merits of a career in the armed forces, may I recommend to all employers the merits of employing ex-service personnel, who, in general, bring with them a better work ethic and better values, and often better skills, than people from outside the armed forces? So I think that we would agree on that matter. We welcome the guaranteed interview scheme and would welcome all assistance.

Andrew Murrison: Most veterans do extremely well in civilian life, not least because of the skills they have acquired while they have been in uniform. However, those who do less well, especially in employment terms, tend to be those who have spent relatively few years in the armed forces, and that is where resources are not focused. What can be done for that particular group of people?

Andrew Robathan: My hon. Friend is right about that, and I know that he takes a particular interest in these things. Of course various factors are at work here, one of which is that some people leave after less than a week and do not stay in touch, in any way, with the armed forces. We are looking at improving the career resettlement advice. Indeed, we are ensuring that everybody now gets a resettlement interview and gets some financial and employment advice when they leave.

Nicholas Dakin: How many veterans have lost the opportunity of a job as a result of the G4S Olympics fiasco?

Andrew Robathan: I have absolutely no idea.

Julian Lewis: On that same theme, does the Minister agree that it would have been good if G4S had recruited more veterans to police the Olympics and ensure security? Will he confirm that what has happened will not result in a single serving soldier in Afghanistan having to stay on the front line for one day longer than would otherwise have been the case?

Andrew Robathan: First, I can confirm that nobody will remain longer on operations in Afghanistan because of this debacle over the G4S contract. I will say to my hon. Friend, as he would expect me to, that I absolutely agree that former service personnel would do that job particularly well, but I have no responsibility for the recruitment
	practices of G4S. However, it appears that it was not recruiting that was the problem but the organisation of the Olympics in general in terms of security.

Mental Health (Soldiers)

John Mann: What additional support he plans to provide for mental health conditions experienced by current and former soldiers.

Andrew Robathan: The Ministry of Defence is committed to offering a high standard of mental health care to those who need it. In his “Fighting Fit” report, my hon. Friend the Member for South West Wiltshire (Dr Murrison) made a wide range of recommendations for improvements to mental health care for both serving and former armed forces personnel. The MOD is working with the Department of Health to implement the recommendations, and I am pleased to report that excellent progress is being made.

John Mann: With the stigma of mental health increasingly being lifted in our society, not least in the armed services, will the Minister take it on himself to ensure that every mental health trust across the country is required, in partnership with his Department, to have an effective strategy for dealing with current and former members of the armed services?

Andrew Robathan: The hon. Gentleman is quite right that the stigma is being lifted. Indeed, there is a programme in the Army called trauma risk management, or TRiM, which means that if somebody appears to have some mental problems, his comrades in arms will go to the chain of command and say that they think that so-and-so is having trouble and should be looked at carefully. We are already deploying extra mental health nurses across the Department of Health as a result of the “Fighting Fit” report. If the hon. Gentleman has not read it, I strongly recommend that he does because it is an extremely good piece of work.

Bob Stewart: Does the Minister agree that it should be a key objective of any Government, whether led by those on the Government Benches or by the Opposition, to look after people who have been mentally or physically hurt in the service of our country for the rest of their lives?

Andrew Robathan: I do agree and I think that those who have been injured mentally or physically in the service of our country and of us all deserve due consideration. That is certainly what we look to give them. In the spirit of co-operation, let me say that I thought the armed forces compensation scheme, which was put in place by the previous Government, was a very good scheme.

Gemma Doyle: Reports show that there is a higher incidence of mental ill health among reservists who have served in Iraq or Afghanistan than among those from the regular forces. Recent announcements make it clear that the Government intend to rely more heavily on reservists in the coming years. Will the Minister say whether the MOD intends to give greater importance to reservists’ mental health,
	and what measures he will put in place to analyse the reasons for the disparity and to improve their mental health?

Andrew Robathan: The hon. Lady is correct, in that it is more difficult to keep tabs on reservists because they go out of the military environment back to their homes and jobs and so on. They also do not have the cocoon, dare I say it, of having their comrades around them. We are taking action, and I want to mention two things in particular. First, the medical assessment programme and the reserves’ mental health programme are currently based in St Thomas’s hospital. We are moving the medical assessment programme to Chilwell in the very near future—

Kevan Jones: Downgrading it.

Andrew Robathan: No, we are certainly not downgrading it. Indeed, I went there only about a month ago to talk about it to those involved, and they think that it is the right way forward.
	Secondly, Professor Simon Wessely at the King’s Centre for Military Health Research is carrying out an in-depth study into the mental health problems that people encounter, particularly focusing on reservists.

Helen Grant: What advice is available to armed forces families on the after-effects of operational deployment?

Andrew Robathan: Not all people suffer after-effects. I believe that my hon. Friend’s son has served or is serving in Afghanistan: is that correct?

Helen Grant: No. Not yet.

Andrew Robathan: He is. Not all people who return from Afghanistan have mental health after-effects, but it is obviously a concern that some people do. Within units in particular, there are various options, including the programme I have mentioned, TRiM, and a programme called the Big White Wall. It is an online programme and people can put their feelings anonymously on a big white wall. There is a huge amount of support, but it is not always easy to access. We want to make it easier for families and others to access that mental health provision—

Mr Speaker: Order. We are extremely grateful to the Minister, but I think that the Minister and the hon. Lady should have a cup of tea together and discuss the matter further.

Defence Manufacturing Industry

Graham Jones: What steps his Department is taking to maintain skills levels in the defence manufacturing industry.

Peter Luff: The “National Security Through Technology” White Paper published in February emphasised the need for a strong skills base in the UK to ensure that the armed forces and national security agencies have access to the technology, equipment and support they need. That is why we are creating the right conditions for
	companies to invest in the UK, encouraging innovative small and medium-sized enterprises, investing in defence science and technology, and strongly supporting responsible defence and security exports. We are also working closely with the Department for Business, Innovation and Skills on a range of initiatives to maintain and develop engineering and scientific skills, including initiating a dialogue with the defence industries similar to that taking place through the successful aerospace growth partnership.

Graham Jones: There are reports today in the newspapers that the F-35B programme is to face substantial cuts in the US. Has the Minister had any indication from his counterparts in the US of a reduction in the number that will be procured, which may affect defence jobs in east Lancashire?

Peter Luff: I remember a good friend of mine, a general, who retired recently from the British armed services, who said he would know that he had retired when he started believing what he read in newspapers. I would strongly recommend to the hon. Gentleman not to believe what he reads in newspapers. The United States remains strongly committed to the programme. The F-35B is an outstanding aircraft, it is flying extensively, and my right hon. Friend the Secretary of State will receive our first two aircraft on Thursday. The hon. Gentleman should be a little sceptical.

Regimental Disbandment

John Baron: What account he took of recruitment capability in determining regimental disbandment.

Philip Hammond: In selecting infantry battalions for withdrawal, the Army has focused on the major long-term recruiting challenges that it faces in this area. It has looked carefully at historic recruiting performance over a decade, and at demographic projections for the age cohort from which infantry recruits are drawn in the recruiting catchment areas of different regiments. It has also considered regional and national affiliations, the merger and disbandment history of individual battalions, and existing commitments of battalions to future operations. The overriding objective has been to arrive at a solution that delivers a balanced and effective military force and is seen as fair and equitable by those currently serving in the Army.

John Baron: Although the MOD has not been able to supply the five and 10-year recruitment figures, despite a named-day written parliamentary question tabled the week before last, the three-year figures clearly show that better recruited English battalions, including the 2nd Battalion the Royal Regiment of Fusiliers, are being axed in order to save the more poorly recruited Scottish ones. Will the Secretary of State deny that petty politics in relation to the Scottish referendum has influenced decisions?

Philip Hammond: My hon. Friend is repeating an assertion that he made when I made the statement. I sat down afterwards with the Chief of the General Staff and went through his process again to reassure myself that I could say with confidence to my hon. Friend that the
	assertion he is making is simply not correct. Looked at over a decade, the recruitment figures for the Royal Regiment of Fusiliers speak for themselves. I am happy to have a meeting with him and go through the numbers, if he would like to do so.

Kevan Jones: Three former senior figures from all three services wrote in The Daily Telegraph this morning of “cynical” cuts to our armed forces and described the plans for Army 2020 as “unbelievable”. Does the Secretary of State not think that with a collapse in confidence at such a high level and morale among the ranks in free-fall, along with his risky strategy on the use of reservists, his decision on 2020 should be another candidate for a possible Government U-turn?

Philip Hammond: As usual, plenty of criticism and no constructive suggestions from the Opposition. In relation to the letter this morning, the key word is “former” senior officers. I take my advice from senior serving officers in the military. This is a plan designed by the Army to secure the future of the Army. They are confident that they can deliver it and I have confidence in their ability to do so.

New Regiments (2006-07)

Philip Davies: What assessment he has made of the effectiveness of the unification of the new regiments created in 2006-07 where battalions were created from previous historical regiments; and if he will make a statement.

Philip Hammond: The Royal Regiment of Scotland, the Duke of Lancaster’s Regiment, the Yorkshire Regiment, the Mercian Regiment, the Royal Welsh and the Rifles were all created in 2006-07. All these regiments have provided battalions for operations in Afghanistan which have been well prepared and which have delivered significant success, as well as all taking significant casualties.

Philip Davies: My right hon. Friend will understand the disappointment in Yorkshire at the disappearance of 2nd Battalion the Yorkshire Regiment—the Green Howards—but can he confirm whether his intention is to have a completely merged Yorkshire regiment in its entirety with the two remaining battalions, which I understand is what the majority of those serving would like to see, or to have the two remaining battalions based on their previous regimental backgrounds, which it seems the majority of retired personnel would like to see?

Philip Hammond: My hon. Friend draws an interesting distinction—not the only one that has been brought to my attention—between the desires of people serving in the Army now and those of former members of the armed forces, because they are not necessarily aligned. I can only repeat what I told the House on 5 July: having announced the changes, we expect regiments to come forward with proposals for restructuring within the boundaries we have announced. We will support decisions made within the regimental families to do that, whichever way they propose going.

Helicopter Capability

David Evennett: What plans he has to improve the helicopter capability of the armed forces.

Peter Luff: The Ministry of Defence is making significant investment in helicopter capability, including: buying an additional 14 Chinook helicopters and modernising the existing fleet; completing the life extension programme for Puma; upgrading the Merlin helicopters and our attack helicopter capability; and replacing the current Lynx fleet with new Wildcat helicopters, the first of which was formally handed over to the MOD at Farnborough international air show last week. My right hon. Friend the Secretary of State also announced a £250 million support contract to sustain these in service. That is a substantial programme of investment that will ensure a strong and credible helicopter capability.

David Evennett: I welcome my hon. Friend’s reply. Will he update the House on plans to marinise the Merlin and upgrade Apache?

Peter Luff: The Department is currently exploring options for upgrading the mark 3 and 3A helicopters as part of an assessment phase for the Merlin life sustainment programme. It will look at obsolescence issues and the ship optimisation upgrades needed for routine operation at sea. All options are still being considered, so I cannot tell my hon. Friend what he wants to know until the conclusions are available. The decision on exactly how many Apache helicopters will be upgraded will be taken at a later date, but we plan to sustain their capability until their out-of-service date, which is 2040.

Brian H Donohoe: The Minister will know of my sincere wish to see air-sea rescue remain within the Department. What contingency plans, if any, does he have on helicopters as far as air-sea rescue is concerned?

Peter Luff: I have every confidence that my hon. Friends in the Department for Transport will secure that facility very successfully during the competition they are running.

Topical Questions

Andrew Selous: If he will make a statement on his departmental responsibilities.

Philip Hammond: My departmental responsibilities are to ensure: that our country is properly defended now and in the future through delivery of the military tasks for which the MOD is mandated; that our service personnel have the right equipment and training to allow them to succeed in the military tasks; and that we honour our armed forces covenant. My first priority is the success of the operation in Afghanistan, followed by the provision of support to the Olympics security plan. The Ministry of Defence has also embarked on a major project of
	transformation to ensure the behavioural change needed to maintain the budget in balance and deliver the equipment programme.

Andrew Selous: As a former Territorial soldier, I have every confidence that our reserve forces will rise to the challenge set by the Secretary of State, as they always have done, but when does he expect the order of battle for the Territorial Army to be announced?

Philip Hammond: As I said, we will publish a consultation paper in the autumn. The consultation period will take us through into the new year and we expect to be able to publish full details of our plans for the Army reserve in the spring, including the order of battle.

Jim Murphy: How many contracts does the Ministry of Defence have with G4S? Will the Secretary of State commit to reviewing them in the light of recent events, and will there be a moratorium on the MOD signing any future contracts with that company until the findings of those reviews have been reported in full to Parliament?

Philip Hammond: I cannot given the right hon. Gentleman a simple answer on contracts we have in place with G4S—

Jim Murphy: Why not?

Philip Hammond: I am quite happy to look into the matter and write to him. Depending on the type of contract being let, the MOD is bound by the regulations binding all Departments—European procurement directive regulations—unless it is a contract for war-like supplies, and must conduct its procurement in accordance with them.

Julian Smith: Can the Minister update the House on the range of protected vehicles available to our troops in Afghanistan?

Peter Luff: Yes I can, and I have heard very moving testimony from those who have returned from Afghanistan, and from the families of those in Afghanistan, about the effectiveness of such vehicles. We have a range of options that balance firepower, mobility and protection, including Huskey, Mastiff, Warthog, Warrior, CVR(T)—combat reconnaissance vehicle (tracked)—Coyote and Jackal; and the latest protected mobility vehicle, Foxhound, which is being deployed to Afghanistan now, will reinforce our commitment to provide force protection and proper protection against the improvised explosive device threat, while providing maximum utility. It is a good package.

Tristram Hunt: The armed forces careers advice centre in Hanley in my constituency is the second busiest in the country, but, under the Defence Secretary’s ill thought out plans, its recruits will not be able to join their local battalion, the Staffords. On recruitment, his numbers are not wrong, but, rather than acting like a desiccated calculating machine, will he support the campaign to keep the Staffords’ name in the Mercian Regiment by merging it with 1st Battalion the Cheshires?

Philip Hammond: On the first point, I take advice from the Army, and that is the correct way for the Defence Secretary to behave in these matters. On the preservation of the name of the Staffords, I am well aware of the concerns expressed by Staffordshire Members of Parliament, and as I said in relation to the Yorkshire Regiment, this is a matter for the regiment. If the regiment comes forward with a proposal to merge the antecedent name into the antecedent names of the 1st Battalion the Cheshires, we will be quite happy to support that arrangement.

Alan Beith: Does the Defence Secretary agree that the Royal Regiment of Fusiliers has done everything that was asked of it in conflict, in peacekeeping, in recruitment and in coping with reorganisation? Why, then, has it been reduced to a single battalion, when its recruitment record is so much better than battalions unaffected by the infantry cuts?

Philip Hammond: I am afraid that the right hon. Gentleman repeats the comments that my hon. Friend the Member for Basildon and Billericay (Mr Baron) made earlier, and that is simply not the case. Looked at over a 10-year horizon, the recruiting figures speak for themselves, and the Army has conducted a rigorous process that resulted in the withdrawal of the 2nd Battalion the Royal Regiment of Fusiliers. I can say no more than that to the right hon. Gentleman.

Dan Jarvis: Significant cuts to the armed forces carry real risk; increased reliance on the reservists carries real risk; and greater emphasis on the private sector for logistical support, again, carries real risk. Will the Secretary of State therefore respond to my concern that the potential cost-saving benefits of the cuts to capability that the Government have announced do not outweigh the risks that they pose to our ability to leverage force in an uncertain and changing world?

Philip Hammond: As usual, there is no alternative constructive suggestion. We have a £38 billion black hole in the defence budget, and we have to resolve that problem to make our armed forces sustainable in future and to ensure that we can properly equip them when we ask them to put themselves in danger. What we have done is to set out a coherent plan that will deliver smaller but better equipped armed forces that are sustainable in the medium and long term, and I suggest to the hon. Gentleman that that is the best way forward for them.

Bob Blackman: I warmly welcome the involvement of the armed forces in ensuring that the Olympic games are safe and secure. Will my right hon. Friend explain the role that they will play during the Olympics and, in particular, the various consultations and engagements that have taken place with the community over the use of ground-based air defence systems?

Philip Hammond: Yes. The armed forces will support the police in the security operations for the Olympics. We will provide the air policing regime, including the ground-based air defence missiles, to enforce the prohibited and restricted zones around London. There will also be
	Royal Marine activity on the River Thames in support of the police, and of course 11,000 people will be deployed in support of the venue security operation. There has been extensive consultation with local authorities, landlords and Members of Parliament on the proposed location of the ground-based air defences.

Graham Jones: Will the Secretary of State update the House on the MOD’s current position in Libya?

Philip Hammond: I am very happy to double-check and write to the hon. Gentleman, but I believe that the position is that we have two MOD personnel on secondment in Libya. [ Interruption .] The Minister for the Armed Forces is confirming that.

David Evennett: Will the Secretary of State join me in paying tribute to our armed forces, who do such a tremendous job? Does he believe that their professionalism will be an asset at the Olympic games?

Philip Hammond: My hon. Friend is absolutely right. Contrary to a lot of the noises off that we have been hearing, most people visiting the Olympic games and most people living in London will be hugely reassured by the presence of our armed forces. They bring resilience and reliability to the security arrangements. When a soldier is scheduled to be at place A at time B, you can bet your bottom dollar that he will be there.

Bob Ainsworth: What will be the effect of the ludicrously last-minute commitment for our armed forces on post-operative leave entitlement for those returning from Afghanistan?

Philip Hammond: I have answered that question in the House before. People who came back from Afghanistan in April will have had their post-operational leave scheduled. It is possible that some people who have post-operational leave scheduled for the period of July and August will be asked to reschedule it. However, I can confirm to the right hon. Gentleman that everyone will receive their full entitlement of post-operational leave, or any other kind of leave, and that people who have to change their personal arrangements and incur any financial loss as a consequence will be fully reimbursed for that loss.

Amber Rudd: Will the Secretary of State confirm that the Scout specialist vehicle will go ahead, giving much needed certainty both to the armed forces and the supplier, General Dynamics, a valued employer in my constituency?

Peter Luff: I can confirm that. The Scout specialist vehicle programme is currently in the demonstration phase. The first vehicle platform test rig was rolled out on 6 June this year and pre-production vehicle prototypes are due to begin delivery from 2013. The successful completion of the demonstration phase will lead to a main investment decision at main gate, currently planned for 2016. That is good news for my hon. Friend’s constituents, and I thank them, through her, for what they are doing to create that important capability for the Army.

Jim McGovern: Constable Colin MacColl of Tayside police came to my surgery last Friday in his capacity as a constituent and someone who works in my constituency. He outlined how distressed and distraught his family are at the fact that his nephew, Leading Seaman Timmy MacColl, was last seen on 27 May in Dubai on shore leave from HMS Westminster. Can the Minister outline what has been done to try to locate Leading Seaman MacColl and what will be done in future to alleviate my constituent’s concerns?

Andrew Robathan: I am grateful to the hon. Gentleman for that question, and I should say that the right hon. Member for Stirling (Mrs McGuire) has been in touch on behalf of the family as well.
	This is a sad case. Leading Seaman MacColl has disappeared. The Royal Navy police made all efforts to find him in Dubai, but unfortunately the ship then sailed, as ships do. We have no particular police presence in the country. We are liaising with the Dubai police, who are leading on the case. The Foreign Office is absolutely on the side of the Dubai police.

Edward Leigh: Would any further cuts in the armed forces be unsustainable?

Philip Hammond: We have announced all the reductions in armed forces manpower required to deliver the outcome of the strategic defence and security review. The changes announced will allow us to deliver the Future Force 2020 structure in 2020.

Jim Cunningham: Will the Secretary of State look again at the cuts to the Royal Regiment of Fusiliers, particularly the impact on Coventry and Warwickshire and the local impact? Can we have an answer without the right hon. Gentleman’s blaming everybody else? He is responsible for the double-dip situation that we have got.

Philip Hammond: I am responsible. I take advice from the Army, which is the only responsible way to decide on a restructuring package for the Army. As I said, I have reassured myself since I made the announcement that all of its elements are sound and based on proper evidence provided by the Army.

Michael Ellis: There is an excellent proposal for 10,000 tickets for the Olympic games to be given to Her Majesty’s armed forces personnel. What procedures are being undertaken for the proper allocation of those 10,000 tickets? Can my right hon. Friend say something about whether, if other tickets remain unsold, it might be possible to give those tickets to armed forces personnel?

Philip Hammond: We are extremely grateful to the London Organising Committee of the Olympic Games for the help that it has provided in making tickets available through Tickets for Troops and directly to the armed forces. We now have a substantial number of tickets available and we hope there may be still more to come.
	The detailed arrangements for distributing those tickets will be determined by the commander-in-chief, land forces.

William Bain: I am sure that the thoughts of all right hon. and hon. Members will be with the families of those who lost their lives in Afghanistan in recent days. What assessment has the Secretary of State made of recent reports that the Taliban believe that the insurgency can no longer be won? Is not this the perfect opportunity to convene all-party talks to bring about a secure peace in Afghanistan?

Philip Hammond: Indeed. The Government’s policy is to maintain the pressure through the military campaign, while encouraging both sides to come together and explore their tentative early contacts, and also to encourage Pakistan to play a constructive role in this process, because, in many ways, Pakistan holds the key.

Richard Drax: A senior military source has told me that many soldiers have been taken off promotional courses as a consequence of the G4S shambles. Will the Secretary of State assure me that they will get back on to those courses and will be fully compensated if their course is delayed by, say, a year?

Philip Hammond: I am not aware of any such cases, but I am happy to talk to my hon. Friend outside the Chamber and to write to him.

John Woodcock: Further to the previous unclear answer, is the Secretary of State categorically ruling out revisiting the “cat and trap” system for the aircraft carriers?

Philip Hammond: I do not think that there was a previous unclear answer. We have made a decision to revert to the STOVL––short take-off and vertical landing—solution. We are highly confident of the delivery of the F-35B STOVL variant, which the US Marine Corps depends on. We have had the highest level discussions with the US Administration, who strongly support the programme. I am looking forward to seeing US Marine Corps aircraft flying at Pax River on Wednesday.

Mr Speaker: Before I call the shadow Home Secretary to ask the urgent question that I have allowed, I must tell the House that I intend to bring proceedings on it to an end after half an hour. In view of the proceedings on Thursday, I ask Members not merely to repeat questions already posed and answered then, but to explore new territory that has since arisen.

Olympics (Security)

Yvette Cooper: (Urgent Question): To ask the Home Secretary to make a statement on Olympic security.

Theresa May: Since I updated the House on Olympic security last week, there have been several allegations in the media, and I want to deal with each of them.
	First, it was reported that Ministers knew there would be a shortfall in security staff last year. This is untrue. Last September, Her Majesty’s inspectorate of constabulary reported, at my request, on the security preparations by the London Organising Committee of the Olympic Games, and it recommended several measures. HMIC reported again in February and concluded that LOCOG had plans in place to deliver the required number of security personnel. Neither HMIC report identified specific problems with G4S scheduling.
	Secondly, it was reported that the Under-Secretary of State for the Home Department, my hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire), who is the Minister for crime and security, had attended meetings in which he was told there was a security staff shortage. In fact, G4S repeatedly assured us that it would overshoot its targets. As I told the House on Thursday, G4S told the Government that it would be unable to meet its contractual obligations only last Wednesday, and we took immediate action.
	Thirdly, it was reported that we must have known about the shortfall because the military was put on standby in April. This is also not the case. In fact, 7,500 troops have been part of the security plans since December, a further 1,000 were on standby in the event of flooding or other such civil emergencies, and we placed a further 2,000 on standby as a precaution in case the threat level increased. The 3,500 troops whose deployment I announced last Thursday are a direct response to the failure of G4S to meet its contractual obligations. A further contingency will remain.
	The Government have strengthened the oversight of the security planning operation since we came into office. I will go through briefly what has happened since the bid for the games in 2005. From the beginning, the organisers planned to use private sector personnel for venue security. LOCOG confirmed that it would be using private sector security personnel well before the 2008 Beijing Olympics. It started the procurement process for security personnel in April 2010.
	When we entered government in May 2010, we instigated a comprehensive review of Olympics safety and security planning, overseen by the then Security Minister, Baroness Neville-Jones. That audit and review identified a shortfall in LOCOG’s venue security budget, which we addressed in the comprehensive spending review.
	We recognised that, with a project of this size and scale, even that additional funding might not ensure the level of security that we needed, so I asked for outside assurance of LOCOG’s venue security planning. In September 2011, I commissioned HMIC to carry out an inspection of LOCOG’s venue security plans. As I have said, that led to several recommendations that were acted on by the Home Office, the police and LOCOG.
	LOCOG and the Home Office monitored delivery throughout the following months. G4S assured LOCOG and the Government continually that it would be able to deliver its contractual obligations. However, on Wednesday 11 July, following the difficulties with scheduling that the company has acknowledged, G4S notified LOCOG and the Government that it would not be able to provide the numbers of security personnel specified in its contract. I want to be clear that that was the first time that G4S admitted to any Minister that it would not be able to deliver the numbers of security personnel that it had promised.
	We acted immediately to make further contingency arrangements by agreeing the deployment of 3,500 further troops. That brings the total military contribution to the games to 17,000, including personnel from all three services.
	G4S has failed to deliver its contractual obligations, but we have the finest military personnel in the world—troops who are willing, ready and able to step in when their country calls—and we can be sure of their professionalism in helping to deliver a secure and safe Olympic games.

Yvette Cooper: Everyone wants the games to be an outstanding success. After the G4S shambles, we need things to be back on track and the Home Secretary needs to show that she is sorting it out.
	First, will the Home Secretary tell us precisely how many people she now expects G4S to provide? It was contracted to provide 17,000, it now says that it will be 13,000, but it has admitted that the vast majority of those are still in process. Today, we learned that only a third of the expected G4S staff turned up to lock down a venue in Manchester and that the police had to do it instead. The monitoring has failed once spectacularly and the Home Secretary has failed to assess the numbers once before. Will she now tell us how many staff she believes G4S will provide?
	Secondly, the Home Secretary told us on Thursday that 3,500 extra troops would be sufficient to fill the gap. If G4S fails to deliver the full 13,000 people it now promises, will those troops be enough? If more troops and police will be needed, she should say so now and not let this drift. The troops and the police will do an excellent job, but they need to be able to prepare.
	Thirdly, the London Mayor said this morning:
	“Everybody that was organising the Olympics knew this was coming up…ages ago.”
	The deputy mayor said:
	“This issue was flagged up repeatedly by both the Metropolitan Police Authority and subsequently the Mayor’s Office…for more than a year to G4S directly, the Olympic Security Board, and the Home Office.”
	Even G4S says that it has been discussing the detailed shortfall for “eight or nine days”. And yet, last Monday, the Home Secretary told the House that she was
	“confident that our partners will deliver”.—[Official Report, 9 July 2012; Vol. 548, c. 9.]
	It is incomprehensible that the monitoring was that poor that no one told her until Wednesday. How on earth could the Minister responsible for delivering Olympics security be the only person who did not know? When was she first told that there was a problem with G4S?
	We need to know why the Home Secretary has failed on this, because we need to have the confidence that she understands what went wrong and is competent to sort the problem out now, so that everyone can get on and make the Olympics a great success.

Theresa May: I will respond to the various points that the shadow Home Secretary has raised. She asked what the numbers look like. The revised solution of more than 23,000 personnel that was decided on at the end of last year was made up of 10,400 G4S guards, 7,500 military at peak, up to 3,000 Bridging the Gap, up to 3,000 volunteers and up to 2,000 incumbents that—

Yvette Cooper: What about G4S?

Theresa May: The very first figures that I gave were 10,400 G4S guards, 7,500 military, 3,000 Bridging the Gap, up to 3,000 volunteers and up to 2,000 incumbent security suppliers at existing venues. [Interruption.] The hon. Member for North Durham (Mr Jones) asks, “Bridging what gap?” Bridging the Gap is the name of a programme under which students and others can get employment.
	The shadow Home Secretary says that we need to get a grip, but that is precisely what we have been doing. When we came into office, we made an immediate security audit, increased the budget and revised the plans. I have commissioned several reports on Olympic preparedness, each of which has led to a refinement of the plans. When G4S told us last Wednesday that it would be unable to deliver its contractual obligations, we decided to deploy extra military personnel to fill the gap.
	The right hon. Lady asked why the situation was not known about earlier. I have explained that we commissioned reports on G4S’s preparedness, which contained recommendations on which LOCOG, the Home Office and the police acted, but those reports all made it clear that subject to acting on those recommendations, LOCOG was on track to deliver the necessary security personnel. Last Wednesday, G4S told us that it would be unable to deliver its obligations.
	The shadow Home Secretary asked about timing. On Friday 6 July the managing director of G4S Global Events told Reuters:
	“We are delivering a London Olympics now. If there was a similar event going on in Australia, I would be bullish that we could deliver that at the same time.”
	I suggest that the right hon. Lady listens to the comments of some of her colleagues. The noble Lord West has said:
	“I don’t think it will affect the security of the games. That’s been taken care of. The Government have sorted that out, because the military are in there.”
	The shadow Olympics spokesman has said:
	“The important thing now is to focus on the solutions.”
	I suggest that the shadow Home Secretary listens to her colleagues.

Nigel Adams: Can the Home Secretary confirm that any costs associated with the additional measures will be met by G4S, not the taxpayer?

Theresa May: I can confirm that G4S has made it clear that it will meet any additional police or military costs.

Keith Vaz: I thank the Home Secretary for agreeing to appear before the Home Affairs Committee as soon as the Olympic and Paralympic games are over.
	May I take the Home Secretary back to the HMIC report? Is she telling the House that G4S was made aware of the contents of the report prepared by Sir Denis O’Connor? There were four copies of that report, and one went to Charles Farr, who chaired the Olympic security board. If G4S was aware that there were shortcomings, it ought really to have put them right before last Wednesday.

Theresa May: The HMIC report was on LOCOG’s security planning capabilities. It was a not a review of G4S. It outlined a number of steps that LOCOG needed to take to plan and manage the delivery of the venue security responsibilities. That predated the decision to increase the number of venue security personnel. A further report was commissioned from HMIC in February, and it said that it was reassured that LOCOG had plans in place to resolve any issue expeditiously. Issues were raised in those reports, but all those who were required to act on them did so.

John Leech: Will the Home Secretary investigate claims that existing G4S staff in other parts of the country have been given the opportunity to fill Olympic security posts only if they take annual leave, despite the massive shortage?

Theresa May: My hon. Friend raises an issue that has not previously been raised with me. I will look into it, but it is of course for G4S to decide how it will provide the numbers. It has had significant difficulties in scheduling both existing staff and the new staff that it is bringing in, but I have noted his point.

Jack Straw: Given the scale of the shortfall between what G4S contracted to provide and what it is now providing, which must have been obvious upon inquiry, is the Home Secretary saying that G4S was guilty of wilful deception of HMIC, or was there some failure in the monitoring of what G4S was doing?

Theresa May: I suggest that the right hon. Gentleman looks at some of the comments that G4S has made about its situation. It may be of interest to the House to know that the accreditation process has accredited more than 20,000 G4S personnel. The problem for G4S has been allocating personnel to particular venue security tasks through its scheduling programme. It was when it examined that situation and saw the difficulties it was having that it came to the Government last Wednesday and said that it could not meet its full contractual obligation.

Andrew Bingham: Will my right hon. Friend confirm that no members of the armed forces involved in the deployment will lose their annual entitlement to leave or be left out of pocket?

Theresa May: I can confirm that absolutely. I understand that my right hon. Friend the Secretary of State for Defence confirmed that in Defence questions.

Bob Ainsworth: We have the finest armed forces in the world, and they will step into the breach most admirably. The lateness of the decision, however, will add considerably to their discomfort and the burden that is placed on them. Given the size of the gap, there must have been a failure of monitoring or deliberate deceit—one or the other—for such a gap to exist so late in the process.

Theresa May: The right hon. Gentleman fails to appreciate the fact that it was at a stage fairly close to the beginning of the Olympic games that G4S began to schedule staff to particular venue security duties. It was when it began doing so that it discovered that it had a problem with the numbers. That is what G4S has absolutely made clear. I repeat to the right hon. Gentleman what I have just said: in fact, we have accredited over 20,000 G4S personnel. The issue was getting staff to the venue security task, and it was right that G4S came to us at the point that it did and said that it was not going to be able to fulfil the personnel numbers, which is why we have asked for the contingency from the military.

James Clappison: So that we can see the full picture, will my right hon. Friend tell us exactly when in the preparations for the games that it was decided that the contract for security would be between LOCOG and G4S, and what was the ministerial input at the time into that decision?

Theresa May: The decision that the contract would be between LOCOG and a private sector contractor was taken under the previous Government, and I am not party to the discussions that took place.

Ian Lavery: The Secretary of State has said on more than one occasion that G4S deliberately deceived the Government. If that is the case in a £300 million contract, will it be allowed to tender for any further private contracts with the Government in future?

Theresa May: A number of Members have hinted at the issue of deceit. G4S did not deceive the Government: it assured us that it could deliver—

Ian Lavery: What is the difference?

Theresa May: Well, there is a very great difference, and I am sure that the hon. Gentleman understands that difference. When G4S recognised that it was having difficulty scheduling and getting sufficient staff numbers to the posts for which they were required it came to the Government and said that it could not deliver the numbers that it thought it could.

Ben Wallace: As we speak and as the House meets, athletes from all over the world are arriving at Heathrow to take part in one of the world’s greatest athletic gatherings. Does my right hon. Friend agree that one of the things that undermines national security is petty point scoring and hysterical opposition, talking the games down?

Theresa May: I absolutely agree with my hon. Friend. The Government are on course to deliver a safe and secure games that everyone will enjoy. We have had good cross-party support until now for the delivery of the Olympic games, and it is a pity that that has not continued under the shadow Home Secretary.

George Howarth: In view of the discrepancy between the account that the Home Secretary has given the House this afternoon and reports from HMIC, the Mayor of London’s office and G4S, will she publish all the relevant contacts that she had with all those bodies so that we can judge for ourselves?

Theresa May: The right hon. Gentleman has made an assumption about differences in statements that have been made. I have explained: if he looks at what G4S has been saying, it made it clear that it realised only recently that it was not going to be able to deliver. It rightly, as a company, put its hand up and said, “We did have problems; it was our mistake.” As I said in response to my hon. Friend the Member for Selby and Ainsty (Nigel Adams), it is willing to provide funding to cover the extra costs that will be incurred. The right hon. Gentleman referred to other comments that have been made. I dealt with some of those in my statement.

Don Foster: Notwithstanding the abysmal failure of G4S to date, is it the intention once the games have begun that G4S will continue to recruit, train and schedule its security staff to Olympic venues, enabling some of our troops to go home early?

Theresa May: It is certainly the case that G4S will continue to provide staff at Olympic venues. Crucially, of course, it will also provide staff for the Paralympics. It will still make a significant contribution to venue security at the Olympic and Paralympic games. There will be more military personnel, and as the hon. Gentleman knows, they have already been informed that they will undertake these duties.

Nick Brown: Can the Home Secretary tell us anything about the incident on Tyneside last Saturday, when 58 employees of G4S were supposed to turn up for work, but 10 actually turned up and the shortfall was made up by the Northumbria police? Will she confirm that Northumbria police will be fully compensated for its costs, and if she cannot tell us anything now, will she investigate the incident further and report back to us?

Theresa May: The example that the right hon. Gentleman has quoted—another example is going across the broadcasts today about the Manchester area—is an exact example of the problem that G4S encountered. In encountering that problem, it identified the fact that it would not be able to provide the security personnel. As to the costs to the police, G4S has stated that it will ensure that it covers the costs for the police and the military, but if the right hon. Gentleman would like me to write to him with more detail, I would be happy to do so.

Eleanor Laing: Will the Home Secretary reassure the House and people who live in areas such as my Epping Forest constituency, which is close to the Olympic park, hosts an Olympic
	venue and, indeed, a Ministry of Defence security site, that normal levels of policing and security that are necessary at this time will not be adversely affected by the current situation?

Theresa May: Of course all parties involved have been working to ensure that the security that is provided is the security that is needed for the Olympic games. That is what is being put in place, and that is why we took the contingency arrangements we did in immediately calling in those 3,500 troops to ensure that we could maintain the levels of security we require.

Dennis Skinner: It is inconceivable that the Cabinet Committee that was overlooking this matter did not spot this—or was it that it believed its own mantra: “public sector bad; private sector good”? Who is on this Committee?

Theresa May: The hon. Gentleman says that the Cabinet Committee should have spotted this, but G4S spotted it only in the last few days. That is what is absolutely clear and that is what G4S has admitted.

Stephen Hammond: Will my right hon. Friend confirm that the failings of G4S will not cost any extra to the public purse in the running of the games?

Theresa May: Obviously, there is a contract between the London Organising Committee of the Olympic Games and Paralympic Games and G4S. There are penalties in it, and it is for LOCOG to deal with, but G4S is on record as saying that it will cover the extra costs of the military and the police.

David Winnick: Could it be the unanimous wish of this House that the British participants in the games do far, far better than the shambles we are now discussing?

Theresa May: I am sure it is the unanimous wish of this House that British participants in the games are going to do extremely well, that we will have a good medal haul and that Members like myself will have constituents who are medal hopefuls—and I wish them every good luck in their competitive events.

David Tredinnick: My right hon. Friend has outlined the checks and inspections that she rightly had in place, but does she not suspect that G4S is, perhaps at the very least, hiding the scale of the problem and has been doing so for some time?

Theresa May: No, I would say that G4S came forward and made a statement to the Government that it would not be able to provide the numbers required. It would have been easy for G4S to carry on saying, “We will provide the required numbers”—but it did not; it recognised that it could not and at that point it came to the Government and we took the necessary action.

Meg Hillier: On 14 December, the chief civil servant in the Home Office gave evidence to the Public Accounts Committee, assuring us that everything was fine with
	the G4S contract. We now hear from G4S that 9,000 people are still being processed. Does the Home Secretary share her senior civil servant’s confidence now?

Theresa May: I explained this on a number of occasions last Thursday and this afternoon. There was a rolling programme for G4S for recruiting individuals and taking them through the training and accreditation process. G4S repeatedly assured us that it was going to overshoot rather than undershoot its target. It came forward and said it could not meet its contractual obligations only last Wednesday.

Ian Swales: The contract is between LOCOG and G4S. What does this situation tell us about LOCOG and its effectiveness in monitoring what is happening?

Theresa May: The contract is obviously between LOCOG and G4S, but LOCOG has been party to discussions over time as we have been revising the numbers required, as all hon. Members know. The HMIC report that I commissioned last year was into LOCOG’s arrangements. LOCOG responded to that and made changes as necessary.

Jack Dromey: Hundreds of West Midlands police officers have been asked to stand in for G4S because its security guards have simply not turned up. The public have confidence in our police service but no confidence in G4S, yet the Home Secretary has spent £4 million promoting privatisation of essential police services, the principal beneficiary of which would be G4S. In light of the Olympics debacle, will she now abandon her reckless plans?

Theresa May: It is not a reckless plan for police forces to look to ensure that they make the best use of their budgets, so that they can put as much money as possible not into back-office functions, but into getting police out on the streets.

Peter Bone: The Home Secretary should have a gold medal for the speed at which she has corrected this problem. Why exactly cannot the 20,000 people whom G4S has recruited be employed? Are people just saying that they are not going to go to work?

Theresa May: There are a number of things, the first of which is the scheduling problems that G4S has had. Some individuals will now say, for a number of reasons, that they do not wish to take up the work. However, the problem was identified only in the past few days, leading to the decision by G4S last Wednesday, when it told us it could not meet its requirements.

Barbara Keeley: There is a similar problem in Salford—not Manchester—to the ones described by my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and my hon. Friend the Member for Birmingham, Erdington (Jack Dromey). Athletes in a hotel in Salford are now being protected by our local police force rather than by G4S. Will our police continue to be overstretched in that way on an ongoing basis? When will they be helped? When will the Home Secretary accept that G4S is clearly not fit for purpose?

Theresa May: Some police forces have put extra personnel on certain venues as a result of what has happened. Hon. Members have made a number of comments about our wonderful military personnel, but we should also recognise that we have the best police force in the world. There are meticulous plans for the policing of the Olympic games and I have every confidence that our police will do an excellent job.

Penny Mordaunt: I understand the political difficulty of issuing a warning order earlier in the year, putting troops on standby for an increase in the threat or for a situation such as this. However, surely it was the right thing to do, not just for the safety of our citizens, but also to enable our armed forces better to plan their R and R and training obligations.

Theresa May: My hon. Friend, with her knowledge of the armed forces, makes a very important point. It is in the interest of our armed forces for us to give them sufficient notice of contingency arrangements. We have had to move on the 3,500 extra troops because of the lateness of the point at which G4S admitted to us that it was unable to meet its personnel needs. On the various other requirements, we have been able to give the notice to which she refers.

Nick Smith: What is the precise number of security personnel that G4S will now deliver for the Olympics?

Theresa May: We are continuing to accredit personnel for G4S and it continues to schedule personnel for the Olympic games. The precise balance of the numbers it will provide will become clear over the next few days—[ Interruption. ] I suggest that Opposition Members should actually look at G4S’s statements on how it is dealing with the issue and on what the problem is. The suggestion that this is a problem for the Government is not the case.

Julian Huppert: When G4S makes a colossal error such as this, the Army and the police step in to provide cover, which is effectively a form of insurance on the contract. What steps were taken when the contract was issued to ensure a level playing field between G4S and other private or public sector providers, and what steps will the Home Secretary take to ensure a level playing field in future?

Theresa May: LOCOG undertook a process of inviting bids for the contract, as a result of which it decided that G4S was the contractor it wished to employ and there is a contract between LOCOG and G4S. We have asked the military to increase the numbers it is making available so that we can provide for the security of the Olympic games and reassure people that our plans for a safe and secure games are in place and that the gap that has opened up will be covered by those military personnel.

John Spellar: The shadow Home Secretary clearly asked the Home Secretary to respond to comments in tonight’s Evening Standard from the Mayor of London and his deputy for policing that everyone knew about this ages ago. The Home Secretary declined to do so. Will she now say why, if the Greater London authority and the police authority knew about the problems, she did not?

Theresa May: I can reassure the right hon. Gentleman that all parties who were involved in preparations for the Olympic games have been working to monitor the arrangements for security and to monitor G4S, and last Wednesday—[ Interruption. ] On 6 July, G4S made clear its confidence in its plan, and last Wednesday, on 11 July, it said that it could not meet the numbers that it was required to provide. We have taken action to ensure that we provide the safe and secure games that I hope everybody in this House wants this country to have.

Julian Brazier: Will my right hon. Friend confirm that one group that has met its target is the reserve forces, more than 2,100 of whom have volunteered?

Theresa May: I am very pleased to confirm that. We have not just the finest regular military forces in the world, but wonderful reservists, who are willing to step up to the plate—including, of course, some in this House as well. I gather that 2,100 reservists have volunteered for the Olympic games. I pay tribute to them and to the work they will be doing.

Joan Walley: Given that the police, as well as the troops, are having to step in and bridge the gap, will the Home Secretary provide us, as Parliament goes into recess, with the numbers of policemen and women in forces around the country who are having to be moved to guard Olympic venues and hotels? It is selling the police short.

Theresa May: The hon. Lady talks as though there was never any suggestion that the police would be involved in security provision for the Olympics. That is not the case: the police have always been part of the security for the Olympics, as has the military. Yes, the police are taking on some extra requirements, as is the military. We all have one aim, and that is to provide a safe and secure games that everybody can enjoy.

Andrew Murrison: Does the Home Secretary agree that a degree of humility on the part of the Opposition is appropriate, as it was Labour’s plans that deliberately downplayed the involvement of the armed forces in the first place? Our armed forces were required then and they are required now. They are among our very best ambassadors and will add materially to the quality of our Olympic games.

Theresa May: As I noted earlier, the decision that LOCOG would have a contract with a private sector contractor was taken under the last Government. My hon. Friend is absolutely right to pay tribute to the quality of our armed forces. I have every confidence that they will not only do a good job, but do so in a spirit that ensures that everybody coming to the games can enjoy them as a sporting event.

Several hon. Members: rose —

Mr Speaker: Order. I thank the Home Secretary and colleagues, whose succinctness enabled 29 Back Benchers to question the Home Secretary in the 22 minutes of exclusively Back-Bench time available. It shows what we can do when we put our minds to it.

Rail Investment

Justine Greening: With permission, Mr Speaker, I would like to make a statement on rail investment. This Government have always been clear that our overwhelming priority is rebuilding our economy and restoring economic growth, to enable this country to compete in the global marketplace in the years and decades ahead. Just as we are dealing with the budget deficit, so we are determined to deal with the massive infrastructure deficit that we inherited. That is why we have taken the deliberate decision to prioritise significant investment in our transport infrastructure—not only in Thameslink, Crossrail, High Speed 2 and hard-shoulder running on motorways, but in relatively small interventions that make a big difference, such as tackling pinch points on our motorway network.
	The huge growth in passenger numbers over the last decade or more demonstrates how much people and businesses value and rely on our railway system. The numbers speak for themselves. Last year, passengers made 1.5 billion journeys, and the number of passenger miles travelled was almost 50% higher than in 2000. Rail freight operators carried 100 million tonnes of goods last year, with freight moved up by more than 15% over the same period. To help to meet that rapidly rising demand, we have already committed to the biggest rail modernisation programme since the Victorian age, with more than £18 billion of rail investment in this spending review period alone, including in High Speed 2 and Crossrail.
	Today, I can announce that we are increasing that commitment, with a further £16 billion of public support for the classic rail network between 2014 and 2019, which will support more than £9 billion of enhancement in line upgrades, greater capacity and more electrification. The high-level output specification that I am publishing today sets out my vision for the railway in 2019, and I would like to take this opportunity to thank the Department for Transport officials and the rail team who have worked with me on that project.
	My vision is for a railway that is cheaper, greener and more reliable to run, that supports economic growth and that delivers for its passengers and freight customers. Passengers are at the heart of that vision, which is about delivering the capacity so that passengers can get to work; helping people and business to get between our cities faster; getting more freight off our roads and on to our railways; and improving access to our ports and airports. I would also like to take the opportunity to thank the many MPs who have represented their community needs to me as I have developed the package.
	At the heart of the high-level output specification is a rolling programme of electrification to deliver more powerful, more sustainable and more efficient trains for passengers and to allow freight operators to use electric trains to haul longer loads at lower cost. Today, I am asking the rail industry to create a new electric spine for freight and passenger services from the south coast to the east and west midlands and south Yorkshire. That electric spine will include the electrification of the midland main line to Sheffield, which will dramatically improve passenger services between London, the midlands and Yorkshire. It could cut journey times by up to 13 minutes.
	It will include overhead electrification between Southampton and Basingstoke, which will be a pilot for possible wider replacement of the less efficient third rail system in the wider south-east.
	I am also delighted to announce that my Department and the Welsh Government have agreed on a proposal for the electrification of the valleys lines into Cardiff and for the completion of the electrification of the Great Western main line to Swansea. That is fantastic news for people in south Wales. I have worked closely with the Welsh Government and the Secretary of State for Wales, who has tirelessly made the case for investment in Wales, and I expect that investment to help to unlock significant economic and employment opportunities in some of the most deprived parts of Wales.
	This is the largest programme of rail electrification that this country has ever seen. The previous Government electrified just 10 miles of railway, but we have now set out plans for more than 850 more miles of electrified railway. By the time that is completed at the turn of the decade, on current estimates, three quarters of all rail journeys in England and Wales will be made on cheaper, greener and more reliable electric trains. With the number of rail passenger journeys expected to increase by 16% over the period, I am also asking the rail industry to provide capacity for 120,000 more commuters into London and over 20,000 more into regional cities.
	Inter-city rail travellers will also benefit from new investments. Those benefits will include the completion of the northern hub project in Manchester; a £240 million investment in capacity and connectivity improvements for the east coast main line, benefiting communities from the home counties to the north-east; and a further £300 million for high-value, small-scale schemes in other parts of the country. That is on top of the improvements to which we have already committed ourselves, including faster journeys from London to Scotland and Wales through the inter-city express programme, and across northern England from Liverpool to Newcastle through electrification of the north trans-Pennine line.
	Passengers also want better transport access to international gateways. As I told the House on Thursday, I am asking Network Rail to develop a new western access rail link to our hub airport at Heathrow. I am also asking for improvements in the vital freight route to Felixstowe port through line and junction upgrades at Leicester, Peterborough and Ely. That will give a significant boost to the rail freight industry, which forecasts a 23% increase in demand by 2019. I am providing £200 million of new funds to support the development of the freight network in order to meet that increased demand.
	I know that, for passengers, railways are often more about stations than about carriages and track. The HLOS programme that I am announcing today will benefit stations at Bristol, Huddersfield and Oxford, and will recognise the value of smaller-scale station schemes by providing further funds for the Access for All and national stations improvement programmes, both of which have delivered excellent results for rail users in recent years. I also know that not everyone can get to a station easily, and that a number of local communities have long wanted to see a new station in their area. I am making £20 million available initially, and asking Network Rail to launch a competition inviting bids for new stations now.
	Vital though that massive programme of investment is, there is another equally important programme that we must deliver to ensure that our railway remains affordable. Sir Roy McNulty’s review identified inefficiencies in our rail industry worth up to £3.5 billion a year. I assure the House that I remain committed to eradicating those inefficiencies, and to sharing the benefits with passengers and taxpayers. Alongside HLOS, I am publishing the funding that I will make available to enable the railway to operate over the period. The settlement is necessarily challenging: it assumes that the industry will deliver the important reforms set out in my March Command Paper and that the benefit will be returned to us all, whether we are passengers or taxpayers.
	That builds on the reforms that we are already making to rail franchises, with longer contracts and more flexibility for operators to innovate in the interests of passengers. We recently published the invitation to tender for Essex Thameside, and I expect to announce the Great Western ITT shortly. I also expect to announce the award of the next west coast franchise over the summer. Today I am publishing revised guidance for the Office of Rail Regulation, which has statutory responsibility for Network Rail’s efficiency, stressing the importance that I—along with passengers and taxpayers—attach to efficiency and value for money.
	Today’s announcement represents another historic landmark in the regeneration and modernisation of Britain’s railways. It represents a recognition that investment in HS2 must not be at the expense of investment in the existing network, and it shows that the Government’s vision for the railways is clear: a railway system that is faster, more reliable, less crowded and more green. Today we are taking real steps to make that happen by delivering on our commitment to deficit reduction through a more efficient railway, recognising our commitment to High Speed 2 by developing the railway and preparing it for integration with the new line, and supporting our economy by bringing people and jobs closer together. That is our vision, that is our priority, and I commend it to the House.

Maria Eagle: I thank the Secretary of State for early sight of her statement, most of which, of course, we read in the newspapers over the weekend and this morning.
	What we have just heard is a list of rail investment projects that were announced by the last Government—[Interruption.] It is true. They were announced by the last Government, but they will have to be delivered by the next one. We were promised £9 billion of new investment, but, as we have heard today, the reality is a plan for just £4.2 billion of new rail schemes over five years—less than half the amount that was spun to the media in advance of today’s statement to the House. Of the rest—the other £5.2 billion—more than half is simply confirmation that schemes already under way will not be cancelled halfway through, including Crossrail, Thameslink, the electrification of the Great Western main line, and the electrification in the north-west and across the Pennines, all schemes announced by my noble Friend Lord Adonis as Secretary of State for Transport in 2009.
	Even many of the supposedly new projects which make up the remaining £4.2 billion are not so new after all, such as electrification of the midland main line, for which development of the economic case was announced by Lord Adonis, and to which we committed at the last election. Today’s U-turn on the Great Western main line is an acceptance that we were right to commit to completing electrification all the way to Swansea, a decision the Secretary of State and her predecessor have spent two years saying had no business case or economic benefit, when it plainly did. I welcome that U-turn; it is a victory for the Labour Government in Wales.
	It is right for the Government to commit to completing the northern hub. That is vital to improve connectivity and capacity between our northern cities. However, instead of that being promised for after the next election, we could have made further progress with the scheme in this Parliament. However, the Government chose to cut investment in this spending period by £1.2 billion, according to Network Rail’s latest delivery plan update for the current control period, CP 4. It says that that has led to deferrals to CP 5, the period covered by today’s announcement. So we have cuts in this Parliament replaced by promises for the next. As the Select Committee on Transport has discovered, the entire northern hub could have been funded this year just from the Department’s underspend, but the Secretary of State instead chose to hand that money back to the Treasury.
	We have also had confirmation today that the Government are determined to press ahead with hiking rail fares by up to 11% in each of the next two years, on top of January’s fare rises of up to 13%. The misery for passengers is not to stop there: we discover from the tender documents for the new franchises that bidders are being assured they can then go on imposing eye-watering fare rises of up to 8% every year. That means more than a decade to come of investment-busting fare rises.
	Will the Secretary of State confirm how much lower investment in enhancement schemes, greater capacity and electrification will be in control period 5 than in control period 4? Can she confirm when work will begin on the ground, actually delivering jobs from each of the schemes that have yet to get under way? Will she update the House on the significant delays in completing the contractual negotiations for Thameslink rolling stock and the inter-city express programme? Will she confirm that she has approved a cut in the planned order of new inter-city trains from 1,400, as planned by Labour, to fewer than 600?
	When will we see the results of the review into train procurement that was promised following the fiasco of awarding the Thameslink contract to a company that will build the trains in Germany? With long-term youth unemployment having trebled in the last year, what steps are the Government taking to ensure that young people benefit from the investment through apprenticeships and jobs? Will the Secretary of State confirm that Network Rail’s debt, now standing at £27 billion, is set to increase to £33 billion by the end of this control period? How much will that have risen to by the end of 2019, as a result of today’s announcement?
	On Network Rail, will the Secretary of State join me in condemning the decision to again propose a bonus scheme that will see senior managers handed £300,000 each, apparently because they have said they will walk away if they do not get it, and then a wider bonus
	scheme that could cost taxpayers £11.7 million? Can she confirm that, as she threatened last time, she will turn up to this Thursday’s annual general meeting and vote against that package, and if not, why not?
	In light of the commitments made to improve rail links to Heathrow, when will the aviation industry actually be allowed to submit evidence to the Department on the country’s medium-term and long-term aviation capacity needs, or do we have this lack of joined-up policy making because we are awaiting the next Government reshuffle?
	Finally—

Mr Speaker: Order. We are extremely grateful to the hon. Lady, but she has now well and truly had her time. I have been watching the clock very closely, the Secretary of State was within time and we must now move on. The Secretary of State will respond and then we will take Back Benchers.

Justine Greening: I have to say that many people watching this will be amazed at the hon. Lady—rather than looking at the glass 95% full, she seems to be looking at it 5% empty. The bottom line is that the Labour Government had 13 years to crack on with this, so if they did not get to do it, they have only themselves to blame. We are in government and we are taking our opportunity to improve our railway system for our people.
	I am delighted that it is a coalition Government who have finally delivered on that programme of transformation for the Welsh railways. It will make a huge difference to the Welsh economy, and I am delighted that we have been able to announce it today. I can assure the hon. Lady that we are looking at whether we can advance some elements of the investment earlier—of course we are. In fact, that comes on the back of a huge amount of work already under way across the industry, be it the work happening at Reading station, Peterborough station and Birmingham station, which is having a huge refit; the work on Crossrail and Thameslink; or the work we have just finished at St Pancras.
	The hon. Lady talked about the inter-city express programme, and we are making good progress in those negotiations. She will be aware that, as and when Hitachi is able to start building those trains, it will open a brand new depot in the north-east, which will create several hundred jobs. I very much hope that it will be the beginning of a story for that region in the coming years that mirrors the one people have seen in the automobile industry.
	The hon. Lady asked about apprenticeships and jobs. Network Rail is playing its role in developing a skilled British work force through recruitment and development. It is taking on 200 new apprentices annually on a three-year programme, and there is now a graduate programme in place, which took about 150 people in 2011. It is also funding an industry-wide track and train programme to give opportunities to unemployed graduates, offering three six-month placements with different organisations. I got to meet some of those graduates earlier this year, and it was outstanding to see them and the opportunities they have been presented with. So a huge amount of effort is already going on in the industry. Today’s announcement will complement that and give the industry the pipeline for the future which will allow
	it to invest not only in its own companies, but in the supply chain that we so badly need to make sure that that work can be supported.
	The hon. Lady asked about Network Rail bonuses. Well, you know what, I am the first Secretary of State for Transport who has ever expressed an opinion on them, so I do not need to take any lectures from the ex-Government, who set up Network Rail and then proceeded to spend the whole time complaining about how it ran itself. It is putting in place its new governance structure, which will be a more responsible one than that set up for it by the Labour Government. It beggars belief that, on a day when we announced such an historic investment, all the Opposition can do is carp from the sidelines. However, I suspect that while that is their strategy they will remain exactly where they are now: on the sidelines.

Several hon. Members: rose —

Mr Speaker: Order. I remind the House that, in accordance with convention, Members who entered the Chamber after the Secretary of State began her statement should not be seeking to catch my eye. It is also obvious that there is very widespread interest in this subject—understandably so—which I am keen to accommodate, but Members will also be aware that there are two Opposition-day debates to follow. Therefore, there is a premium on brevity from Back Benchers and Front Benchers alike.

John Redwood: Over the past two years Network Rail has announced losses of £344 million on its very large derivatives book, so would not a better way of spending that money be to have a national programme to replace dangerous level crossings with bridges and underpasses—and could that start in Wokingham, please?

Justine Greening: My right hon. Friend raises an important point about passenger safety. In fact, the railways are one of the safest modes of travel we have. We have announced £65 million today to see continued improvement in level crossings. I would be very happy to meet him to hear his concerns about his local station, and I am sure that Network Rail, which takes the decisions, will also be interested to hear those concerns.

Louise Ellman: This is a welcome investment announcement, but it appears to be based on the industry finding an as yet unidentified £3.5 billion of savings. If those savings are not found or if the cuts involved are not acceptable, which of today’s announcements will not take place?

Justine Greening: I believe that the savings will be found. We have a work programme in place and for the first time the industry has come together. Sir David Higgins, when he appeared at the hon. Lady’s Committee recently, committed to reducing his costs base by 20% and said that he was keen to go further. I believe that we have a plan in place to work with the industry. Critical to that is not constantly reorganising it, as it is time for it to stay where it is and work together better.

Philip Hollobone: I commend the Secretary of State for her statement. The upgrade and electrification of the midland main line will be hugely welcome in Kettering. Will she announce the details of the upgrades that will take place along the midland main line, because that is a crucial part of the investment that she has just announced?

Justine Greening: There will be a variety of upgrades of junctions, tracks and capacity. One key aspect of today’s announcement is the removal of some of the bottlenecks that often stop passenger trains going as fast as they can. Many of us will have been on a passenger train while it travelled at what seemed to be quite a slow pace. That is often because it is stuck behind a freight train. A number of the smaller improvements we are making today will mean that that happens less and that will be one of the things we can do to improve my hon. Friend’s line.

David Blunkett: It would be churlish not to welcome the fulfilment of a Labour pledge to electrify the midland main line and to make the associated improvements. Will the Secretary of State tell us exactly when those improvements and the electrification will begin?

Justine Greening: The improvements will take place over the 2014 to 2019 period, as the project is developed and rolled out. I have worked hard to ensure that Sheffield has a good transport package from the Department. Another thing that I managed to get sorted out, which the right hon. Gentleman’s Government never did, was £3 million for a footpath bridge over the railway line, which will mean that his community and others around that area can get into Sheffield from the other side of the railway track. I believe that that, alongside the midland main line scheme and the capacity changes, means that by 2019 he will see a much better service.

John Leech: The Labour chairman of Transport for Greater Manchester said of today’s announcement:
	“Taken together, these investments will change the face of rail services in the North of England in a manner that has not been seen for several generations.
	The Northern Hub and electrification programmes will be a catalyst to help drive economic growth across the north”.
	I could not agree more. Does that not prove the commitment of the coalition Government to rebalancing the economy and bringing investment and jobs to the north of England?

Justine Greening: Absolutely it does. It is this Government who have brought forward the investment plans for the northern hub and been prepared to finance them and it is this Government who have gone on with High Speed 2, which is critical in the longer term for improving connectivity across the whole country. It will particularly benefit the great northern cities, one of which the hon. Gentleman represents.

Jack Straw: I assume from the welcome reference in the Secretary of State’s statement to high-value, small-scale schemes that she accepts that, to avoid a two-tier railway, lines such as the
	Blackburn to Bolton line are in urgent need of doubling and improvement. What progress is likely to be made on that?

Justine Greening: The good news is that our investment in the northern hub opens up more capacity on that stretch of the line. Of course, the decision about how the capacity is then used is a local and regional decision. For the first time, the opportunity will open up and I am sure that the right hon. Gentleman will want to make his case to his local passenger transport executive.

Stephen Dorrell: I welcome the whole of my right hon. Friend’s statement and, in particular, her decision to go ahead with the long-promised and often delayed electrification of the midland main line. Is that not a clear example of action by the coalition following years of broken promises from Labour?

Justine Greening: It absolutely is—my right hon. Friend has been a tireless campaigner to get that investment which communities such as his have so long needed. We are going to get on with the upgrade and the electrification of the midland main line. That will also, incidentally, release long-distance diesel trains, which we can potentially cascade on to other parts of the network, so it will have benefits that go far broader than just the midland main line.

Hugh Bayley: Will the Secretary of State make sure that the electrified midland main line connects to the first phase of High Speed 2, so that Yorkshire gets classic compatible trains running fast from London via Birmingham to Yorkshire just as quickly as Manchester? Will she reflect on her claim that only 10 miles of track was electrified under Labour? After all, High Speed 1 from the channel tunnel to London, a brand-new electric line, was built when Labour was in power.

Mr Speaker: I gently say to the hon. Gentleman, for whom I have the highest regard and affection, that if he is going to ask a question about High Speed, there is real merit in asking a high-speed question. From now on, we need short questions and short answers. I say that in the interests of colleagues whom we wish to accommodate.

Justine Greening: The hon. Gentleman raised the question with me only last week in a meeting that I had with him on High Speed 2. As I said to him then, there are some challenges in doing as he suggests, but one of the most important aspects of the High Speed 2 business case is to ensure that as many communities as possible are connected up with it, and that we do that as soon as possible. I have no doubt that we will continue to look at whether those options are available to us and we can progress them. In the meantime the great news for him is that we will see High Speed coming up to his part of the country and it will hugely benefit his community when it gets there.

Rob Wilson: May I thank my right hon. Friend and the Chancellor for backing the campaign that I led for western access to Heathrow, which will connect Reading directly to the nation’s hub airport? Does she agree that the £500 million investment
	offers the opportunity for further private sector involvement and investment to ease pressure on the taxpayer and also on ticket prices?

Justine Greening: I think that it does. In the Department for Transport we are keen to look at how we can more efficiently and effectively leverage in private sector investment. We were able to do that recently on the local authorities’ major road schemes and we should look to do it also on rail schemes where we can. Interestingly, on the £500 million project that we are taking ahead for that western rail access to Heathrow, more than 90% of the benefits will go directly to businesses, so it is a real catalyst for growth in the Thames valley area.

Paul Flynn: Does the Secretary of State’s announcement mean that the Ebbw Vale line will be modernised so that trains can run directly to the heart of Newport?

Justine Greening: That is a very good point. The electrification will open up a range of possibilities—[Interruption]—and it will massively improve journey times, as well as the quality of service. I can hear hon. Members on the Opposition Benches chuntering, as if somehow we have just made a bad announcement. It is a transformational one. It will drive growth and jobs in south Wales and we should all welcome it wholeheartedly.

Iain Stewart: As chairman of the all-party group on east-west rail, I thank my right hon. Friend for announcing that her new line is to be electrified. As a diesel route it was due to generate 12,000 new jobs in the region. Can my right hon. Friend set out what additional benefits she expects an electric route to deliver?

Justine Greening: I think it will mean a lower cost railway and lighter trains which are more efficient and reduce maintenance costs. They are more reliable trains and they open up better opportunities for scheduling than we have had in the past with diesel trains. It is a huge investment which will massively impact on my hon. Friend’s local community and it opens up the possibility of seeing whether we can extend that line further towards east Anglia in the coming years.

Kelvin Hopkins: Will the Secretary of State give her backing in principle to rail freight infrastructure capable of carrying full-scale lorries and lorry trailers on trains between the channel tunnel and Britain’s major conurbations?

Justine Greening: I am not sure whether I can give the hon. Gentleman the categorical in-principle assurance that he wants, but I am sure he will welcome the fact that a huge chunk of the investment will help get more freight off the road and on to the railways, and of course the electric spine project is one of the key ways in which we can do that. There is also investment in Felixstowe so that we can continue to get containers by rail. Importantly, one of the other pieces of work in which we are engaged is improving the gauge so that it can take bigger containers than it is currently able to take. That will open up easier travel by rail for the container market.

Paul Maynard: I welcome with inexplicable joy the announcement on the northern hub, which I have waited to see for so many years. Will the Secretary of State confirm that the amount of investment in the north-west, Yorkshire and the north-east puts to bed any notion whatsoever that the north does not get its fair share of Government funding?

Justine Greening: I absolutely think that. As someone who was born and bred in Yorkshire, I think that the sort of investment now going up to the north of our country is absolutely critical. There is so much talent up there; we just need to make sure we invest to unlock it.

Derek Twigg: The Secretary of State mentioned small interventions that make a big difference. Do her plans include any proposal to look at the Halton curve in Cheshire, which is an important project for both Cheshire and Merseyside, and if they do not will she go away and look at it again?

Justine Greening: That is more of a local scheme, but I will certainly undertake to look at it and see whether I can get back to the hon. Gentleman with some more details.

Jo Johnson: I welcome the announcement of a £700 million investment for reducing overcrowding and congestion in London and the south-east. Will my right hon. Friend kindly look at the causes of overcrowding on Southeastern’s routes to Orpington, which, extraordinarily for a station of its size, has no fast trains at all during peak hours?

Justine Greening: My hon. Friend is right to raise the issue of capacity in London, particularly on his line, which I know local MPs have had real concerns about. We are looking to work closely with operators such as TfL to see what we can do together to improve those services over time. As I said earlier, 120,000 more people are catered for in these plans, which we have worked up very carefully. I think that it is very good news for commuters in London.

Brian H Donohoe: I welcome the statement, if it is not in fact one about jam tomorrow. In those circumstances, can the Secretary of State give some indication of what additional resources will be put into the railway system this side of the general election and, in particular, how much extra will be paid to the Scottish Parliament?

Greg Mulholland: rose—

Lindsay Hoyle: Order.

Justine Greening: The hon. Member for Central Ayrshire (Mr Donohoe) will know that transport in Scotland is a devolved matter. He will also know that in the spending review we have committed £18 billion for the railway network, an outstanding amount of investment that can make a huge difference. Of course, today’s announcement adds further to that pipeline. I think that the certainty it will give the industry about the investment coming down the track will really help to ensure that we get the
	most out of the improvement not only for passengers and freight, but for jobs and growth, particularly in the railway industry.

Greg Mulholland: Thank you, Mr Deputy Speaker. That is probably the closest I will get to the Dispatch Box—[Hon. Members: “Hear, hear!”]—in this Parliament. In the last Parliament Labour’s contribution to tackling congestion in Leeds was cancelling the Leeds supertram and continuing to insist on a no-growth franchise for Northern Rail. Susie Cawood, from the Leeds, York and North Yorkshire chamber of commerce has said:
	“The chamber welcomes government investment in the rail network…Continued investment is essential to ensure we remain competitive and continue to attract inward investment and grow our existing businesses—

Lindsay Hoyle: Order. The hon. Gentleman should not take advantage of a situation. Many Members want to get in and this has to finish at five past 5. In fairness, we all have to get in.

Justine Greening: The hon. Gentleman is absolutely right that this investment will make a big difference to Leeds. It is not just on the back of the north trans-Pennine express electrification. He will also know that the £240 million investment in the east coast main line will also improve services for his constituents. Of course, he will be aware that in the longer term we are investing in High Speed 2, which will have a stop in Leeds.

Diana Johnson: Despite my constituents paying ever higher fares to travel by train, Hull will be the largest city in this country without electrification. Why is that?

Justine Greening: We are working our way around the UK. In fact, by the end of this decade around three quarters of passenger miles will be on electrified railways. I can assure the hon. Lady that the Government absolutely want to progress electrification—it is better for the railways overall, it has a good business case, and it is good for the environment—but obviously we still have to cut our cloth to meet the public affordability needs, which is what we are trying to do. She will know that I have taken a real interest in her area, which is one of the reasons why, while I have been Secretary of State for Transport, we have halved the tolls on the Humber bridge.

Anna Soubry: This is a great day for Greater Nottingham, which has waited many years for the electrification of the midland main line. Can the Secretary of State, whom I thank from the bottom of my heart, confirm that it will give a real economic boost to Beeston in my constituency, to the enterprise zone, and to the business park which is bang opposite the station?

Justine Greening: I am absolutely sure that it will. We are developing a fantastic midland main line for what is a fantastic city.

Ian Lavery: We have got the lines, we have got some stations; the only problem on the Ashington-Blyth-Tyne line is that we have not got any
	trains. Can the Transport Secretary explain how much of the £9 billion investment will go towards reopening the Ashington-Blyth-Tyne line?

Justine Greening: We are looking at whether there is any possibility of opening lines. Our main focus has been on whether we can improve stations, and in fact open new ones, but over time we may be able to unlock some of those local decisions through the Department’s decentralisation approach. We have just consulted on that, some very interesting responses have come through and I hope that we will make some announcements later. I take the hon. Gentleman’s point with real interest.

Therese Coffey: May I say how delighted we are about the Ely North junction? It is great news for East Anglia and for unlocking freight from Felixstowe, and we commend the Secretary of State on it. What further junctions can we look forward to for unlocking freight?

Justine Greening: My hon. Friend has raised the issue tirelessly and recently had a Westminster Hall debate on the topic, and it is campaigners such as my hon. Friend who have really powerfully put the case to Ministers for looking at the issue and seeing what we can do to tackle it. The Ely junction will be done, and it matters massively, because it creates the potential for enhanced passenger services between Cambridge, King’s Lynn and Norwich, so it will have broader benefits, including freight, which, with Felixstowe nearby in her constituency, I know is close to her heart.

Huw Irranca-Davies: While indeed welcoming the news that an electrified train will be heading down the tracks to Swansea, and to Maesteg, at some point in the future, we note that there is a two-year delay, so when will the train be arriving in Swansea, and when in Maesteg?

Justine Greening: I assure the hon. Gentleman that we are cracking on with the programme now, and that is precisely why it has been announced today as part of our priority for the next control period. We will work on it with the Welsh Assembly Government, and I am sure that we will be able to release more details to him shortly.

Andrew Turner: Of every 100 people, a mere three travel by train. A huge subsidy is proposed for the £870 million loss that covers CrossCountry Trains and East Midlands Trains, and that does not even cover the infrastructure costs. How are we to justify such massive expenditure that will benefit so few?

Justine Greening: Our investment proposal today is about making sure that we have a railway network that can cope with the level of demand in coming years, and that is absolutely critical for our economy, but my hon. Friend is right that we have to ensure that the railways are efficient, and a railway system that every year costs us £3.5 billion more than it needs to is not acceptable. That is why in order to address efficiency we have some difficult challenges ahead of us, but we are going to work with the industry to do that, because the points that he makes are absolutely valid. We have to tackle
	inefficiency. Well run organisations provide a better service to their customers, and I am determined to turn the railways into a well-run organisation.

George Howarth: I welcome the Secretary of State’s statement, but can she assure me that the west coast main line franchise will not be determined on the basis of job cuts and a corresponding reduction in service to the travelling public?

Justine Greening: We have been very clear about wanting to see improvements in the west coast main line service, and we have actually seen passenger numbers on that franchise grow rapidly over recent years. We want to see those improvements continue and, at the same time, value for money for the taxpayer. I hope that some of the investment that we are putting in across the network today will help support all that, and the right hon. Gentleman will obviously be interested to see the outcome of the tender process later on.

David Rutley: Unlike Opposition Members, I welcome today’s statement. Will my right hon. Friend confirm that the northern hub electrification will lead to improved journey times, more frequent trains and much better connectivity between the great towns and cities in the north-west of England?

Justine Greening: Yes, yes and yes.

Meg Munn: I, too, welcome the electrification of the midland main line. [Hon. Members: “Hooray!”] But a letter from the Minister of State, the right hon. Member for Chipping Barnet (Mrs Villiers), arrived in my inbox shortly before this statement. It says:
	“Completion of Midland Mainline electrification is proposed for 2019.”
	That is seven years away. Given the increasing north-south divide, I urge the Secretary of State to bring it forward so that we get the benefits more quickly.

Justine Greening: To reassure the hon. Lady, I should say that we are looking at whether we can commence some of the investment earlier. We have had to set out our basic proposals, of course, but let us be clear: today we are setting out a statement of output—what we want to get out of the railway system. It is now for the industry to go away and look at how it can achieve the outcomes that we are specifying. The midland main line electrification is one of the key, explicit schemes that we have said we want to bring forward. If the industry has a proposal to do it faster than the timeline that we have mentioned, I have no doubt that we will be very interested in looking at it.

Bob Russell: The Secretary of State is fully aware of the east of England rail prospectus. I put it to her that for those of us served by the Greater Anglia line, her statement today is very disappointing. When might we expect the entire east of England rail prospectus to be implemented?

Justine Greening: The hon. Gentleman will see improvements in services and capacity over the coming years. Many of the improvements that we are announcing on the network today can improve his area, too—not
	least through the potential to improve stations and see access for all stations brought to his area. There is also investment in safety at level crossings and the general pots that we put in place to improve passenger experience and the strategic freight network. There is a huge number of different aspects to the investment, and I am sure that many of them will relate to the hon. Gentleman’s community.

Sammy Wilson: Will today’s announcement have any budgetary implications for devolved Administrations through the Barnett formula? What practical measures has the Secretary of State put in the procurement provisions to ensure that her aspiration of jobs for British industry and the UK supply chain is realised by this investment?

Justine Greening: On the hon. Gentleman’s point about jobs and growth, I should say that absolutely I have looked not only at what we need on our network and the investment profile but at getting a really clear understanding on how the measures can help support jobs and growth, particularly in the railway industry.
	The hon. Gentleman knows that I am keen to make sure that the money that we are spending as a Government benefits not just passengers but the industry, in creating more jobs. We will continue to look at how we can make sure that our procurement processes work effectively and I certainly hope that we can do more to support our industry than the last Government.

David Tredinnick: Will my right hon. Friend confirm that the journey time from Leicester to London will now be under an hour, at 58 minutes, and that we will get new electric trains? Will she be straightening out the Harborough curves, which have long been an obstacle to electrification?

Justine Greening: I can confirm those journey-time improvements for my hon. Friend’s constituents, who will welcome that, as I do. On the particular aspect of the curves, I will make sure that I write to him so that I get my facts right, but I hope and believe that there will be a positive response on that, too.

Kevin Brennan: I am glad that the Secretary of State was able to work positively with the Welsh Government over the electrification of the valley lines and the extension to Swansea. Has any financial contribution from the Welsh Government been involved?

Justine Greening: The hon. Gentleman is right to say that we worked closely not only with the Secretary of State for Wales but the Welsh Assembly Government. I met Carl Sergeant a few times to discuss these proposals. As regards how the financing will work, the basic scheme for the valleys is £300 million. That is funded through track access charges that franchise operators will pay. It pays them to do this, because they save money through electrification, which reduces their operating costs. Once the valleys electrification has been completed, that, in essence, will electrify the line to Bridgend, which means that the final piece to Swansea becomes worth doing. It also simplifies our rolling stock procurement.
	The final piece of the Bridgend to Swansea electrification is being funded by the UK Government to the tune of £50 million. All in all, it is a good deal for Wales.

Jessica Lee: I welcome the announcement that a fund will be made available to consider applications for railway stations to be opened. My right hon. Friend will recall a meeting earlier this year with me and representatives from Derbyshire county council regarding the Ilkeston train station project. There is a strong regeneration case for that important project, and it is well matched with the fund that has been announced today, so does she, too, hope that it can be delivered?

Justine Greening: Ultimately that will be a decision for Network Rail. Let me be clear, though, that it was the meetings I had with my hon. Friend and her local councillors that brought home to me the fact that money needed to be set aside to make sure that new stations can be opened for the communities that need them where growth is happening. I very much hope that her Ilkeston station plan will go forward to the competition bid, and I will look with real interest to see it come through.

Jeremy Corbyn: Does the electrification programme include the electrification of the Barking to Gospel Oak section of London Overground? I had a meeting with one of her colleagues about this some months ago. It would make freight transportation from the east of England easier, improve passenger services, save a lot of money, and be environmentally sensible. Will she go for it?

Justine Greening: I take the hon. Gentleman’s point. That is not part of the electrification plans that we have announced today. Ultimately it is for Transport for London to fund it if it wants to do so, but I am sure that it will take on board the points that the hon. Gentleman has made and, if the business case stacks up, might consider it.

Tony Baldry: I thank my right hon. Friend for all that she is doing on the east-west rail link. It has been quite difficult keeping up with all the good news today. Will she therefore arrange to put in the Library a map of the national rail network as she envisages it in 2020 and in 2025 so that we can share it with our constituents?

Justine Greening: I will make sure that that is done. My hon. Friend will see huge swathes of the network being newly electrified and pockets of growth in our key cities where we are now meeting demand.

Barry Sheerman: The Secretary of State should be congratulated on any investment for our country, for the Yorkshire region, for the northern hub and for Huddersfield, but according to the classic economic theory of Keynes, this country is in a deep recession, and we need this investment now, not in two years’ time.

Justine Greening: To provide the hon. Gentleman with some reassurance, we are getting on with huge amounts of investment right now. Of course, if we want to be ready to get the next pipeline kicked off in 2014, we have to announce it today so that the industry can start to look at what we want and then come back with proposals on achieving it. He is absolutely right to say that projects such as the northern hub are crucial. I am very proud and pleased that we have been able to announce that investment, and I look forward to working with him as we develop these proposals.

Andrew George: Welcome as today’s announcement is, and although I hate to rain on the right hon. Lady’s parade, I fear that they will not be dancing in the streets of Penzance by the end of the week if the Government go ahead, as we suspect, with reducing the service by a third. Will she reassure my constituents that this welcome investment in and improvement of the rail service across the country as a whole is not built on the back of cuts to the service to Penzance?

Justine Greening: I am aware of the hon. Gentleman’s concerns, which he is going to talk through tomorrow with the Minister of State, Department for Transport, my hon. Friend the Member for Chipping Barnet (Mrs Villiers). I assure him that no final decisions have been made. I emphasise that the HLOS investment that we are making will open up real opportunities for us to cascade rolling stock. For example, the high-speed diesel fleet that is currently on the midland main line—the Meridian stock—will be available, and we will see how we can use that effectively on other parts of the network.

Chris Bryant: The people of the Rhondda Fawr will doubtless want to get out the bunting and skip for joy—[Hon. Members: “Hear, hear!”] They will doubtless want to do so when the Treherbert to Cardiff line has been electrified. What date should I put in my diary for the opening of that electrified line? Will it happen before the review of constituency boundaries and before Lords reform, or perhaps after?

Justine Greening: It is nice to know that the hon. Gentleman looks at things through such a political lens, rather than from the perspective of his local community. This investment will take place from 2014 to 2019. It will make a huge difference to communities such as his. I only wish that he could support it wholeheartedly and without reservation.

Eric Ollerenshaw: May I add my congratulations to my right hon. Friend on how much she is doing in the north-west to deal with the neglect of the previous Government? What will she do about towns such as Fleetwood in my constituency, which had 13 years of rusty railway lines and still have no trains on them?

Justine Greening: That is really a local matter for my hon. Friend’s regional passenger transport executive. As he will know, we are electrifying the Manchester to Blackpool railway line, which will provide real benefits. I am keen, as colleagues across the House know, to
	understand what people want next. If I know what they want next, I can set about seeing whether we can provide it.

Jonathan Reynolds: I am pleased that the northern hub is proceeding. It could give us six trains an hour between Manchester and Leeds, running through my constituency. Does the Secretary of State agree that it would be wrong to sacrifice local services, such as those connecting Mossley and Ashton, to make way for extra inter-city services, and that the train operating companies should use any extra capacity and infrastructure to improve services for everybody?

Justine Greening: We are careful to ensure that we understand the impacts of the northern hub. For example, today’s announcement includes increased capacity at Huddersfield station to maximise the benefits of the northern hub investment. We will continue to look at how we can do that across the whole of the network. I believe that this project will be hugely influential in unlocking economic growth across the Pennines—linking up the areas as they have always wanted.

Elizabeth Truss: I thank my right hon. Friend for her commitment to upgrade the Ely North junction. May I ask that half-hourly services to King’s Lynn be specified in the Thameslink franchise agreement in 2013 and the Norwich to Cambridge franchise agreement in 2014 so that passengers can see the benefit of that upgrade?

Justine Greening: It is too early to say exactly what will be specified in the franchise contracts, but many of the investment proposals that we have put in place today, which the industry will come back to us with more detailed versions of, allow the potential for more frequent services. I know that that is exactly what communities such as my hon. Friend’s want. We are building headroom for growth into the railway network for the communities that need it.

Jonathan Edwards: I find myself in the strange position of congratulating the Government on their statement. It goes part of the way to making up for the historical underfunding of the Welsh railways. The north Wales coast line and the line west of Swansea are vital links between the mainland and Ireland, which is a major trading partner of the Welsh economy and the wider UK economy. What discussions are happening between the Department, the Welsh Government and European institutions about using Wales’s share of HS2—

Lindsay Hoyle: Order.

Justine Greening: I understand the point that the hon. Gentleman is making. It is a relevant question. The Welsh Government have not raised that issue with me directly, but it is something that I am interesting in considering. Perhaps he will forgive me if I reflect and get back to him as my thinking on HS2 develops.

Henry Smith: Does my right hon. Friend agree that the reported contention of the Opposition that this significant rail investment will not create jobs is completely absurd?

Justine Greening: It is totally absurd. Of the £9.4 billion of investment, up to half could benefit business directly. It will be massively important for local economies and for jobs and growth. Its effect will go well beyond the rail industry, for example by connecting up airports and ports. My hon. Friend’s local airport at Gatwick is receiving investment for its station. All those things are important in providing our country with a joined-up transport system that supports efficient end-to-end journeys for passengers and businesses.

Jonathan Ashworth: The Secretary of State will know that there has been a huge cross-party campaign for electrification of the midland main line, so I am delighted to welcome her announcement, including what she said about the upgrade of the Leicester junction. She will know that commuters want that work to start as quickly as possible, so will she undertake that it will start closer to 2014 than 2019?

Justine Greening: It depends on the industry’s response to the outputs that we have said today we want to achieve. I can assure the hon. Gentleman that I do not generally let the grass grow under my feet. I like to get on with things and get them sorted out, so we will get on with all these projects as fast as we can.

Duncan Hames: What a tremendous statement! Lighter electric trains accelerate and decelerate faster, allowing for intermediary stops serving communities such as Corsham, in my constituency, as long as we are successful in winning a new station in the competition that the Secretary of State has announced today. Will any of that multi-million-pound fund be available before control period 5?

Justine Greening: I am looking at how the competition and the bids will work, and I believe we can get a lot of learnings from how individual communities and local authorities respond. We can see how the local authority major roads programme worked—it was an effective process in getting local authorities to work with local enterprise partnerships and say what their road network needed. I am interested to see how this pot of money can do the same thing for new stations in communities such as my hon. Friend’s. Once we have got those learnings, there is no reason why we cannot start to pull forward that investment.

Paul Blomfield: I welcome the Secretary of State’s statement, but may I ask her for further clarification of her earlier answers about track improvements? In particular, will the programme include track improvements at all three bottlenecks on the midland main line—Derby, Leicester and Market Harborough —without which we will not get the targeted improvements in journey times?

Justine Greening: I will need to confirm that specific point, but I am certainly aware that track improvements will happen at Leicester. I believe that they will also happen at Derby, but I will need to find out about Market Harborough and write to the hon. Gentleman.

Peter Bone: Rail passengers in Wellingborough will warmly welcome the statement, but does the Secretary of State share my concern that
	the announcement was leaked to the press in advance of being given to Parliament? Would she express her surprise that the Deputy Prime Minister was on television promoting the statement, apparently in breach of the ministerial code?

Justine Greening: I was concerned. This is obviously an important announcement, and I can understand why people would be keen to make it. I e-mailed and wrote to all Departments to emphasise to them when the announcement was embargoed until, so of course it was disappointing to see some of it leak out earlier.

Nia Griffith: I thank the Secretary of State for her close working with the Welsh Government and for listening to the lobbying from south-west Wales, ably led by my hon. Friend the Member for Swansea West (Geraint Davies). I also thank her for the comments that she has just made about looking further west. Will she give special consideration to starting the project to Swansea in time for the Dylan Thomas centenary year in 2014?

Justine Greening: I believe that may be something of a stretch, but we will wait to see what the industry says about how quickly it can deliver the plan and develop the proposals. There is a lot of work to be done, but the most important thing is that we have signalled that it is going ahead. I appreciate the support of the hon. Lady and her colleagues, and I have to say that I have had a huge amount of lobbying by Government MPs from Wales as well. Together, they have made a real difference by getting across the case for investment.

Jason McCartney: I very much welcome the fully funded northern hub project, the investment in Huddersfield railway station and the new station fund, which my community of Milnsbridge may go for. Will the Secretary of State confirm the importance of connectivity and local stopping services, so that people in Slaithwaite, Marsden, Lockwood, Honley and Brockholes get full benefit from this transformational announcement?

Justine Greening: We want many communities to benefit from the announcement, and frankly, the more people we can get on the railways, the more successful they will be. That means connecting as many communities as possible, which is the approach that I am taking to High Speed 2 and to the current network. That is one reason why, for the first time, I have set aside some money for new stations.

Frank Dobson: As the Member representing St Pancras, may I ask the Secretary of State whether she is really satisfied that it will be 2019 before the first electric train arrives from Sheffield at that magnificent station, which was so magnificently refurbished under the Labour Government to provide a connection for the channel tunnel link and fast trains to the Olympic games?

Justine Greening: The right hon. Gentleman looks forward, as I do, to a time when trains that arrive at St Pancras are not dirty diesel trains but clean electric
	ones. I think that that will have a positive impact on the environment in that station. St Pancras station is an amazing building. It is impossible to walk in without gasping at the wonderful architecture, and those of us who want more members of the next generation go into design, technology and engineering should take them to St Pancras, which will get them fired up.

Several hon. Members: rose—

Lindsay Hoyle: We have only five more minutes—let us try to get through as many questions as possible.

Heather Wheeler: I thank my right hon. Friend and all the Ministers and Parliamentary Private Secretaries who have worked hard with all the local MPs to make sure that this new electrical spine is achieved. The point is we have a spine, and we waited 13 years for someone else to find one.

Justine Greening: I do not think I could put it better myself. My hon. Friend is absolutely right.

Geraint Davies: In 2014, we celebrate the 100th anniversary of Dylan Thomas’s birth. May I thank the Secretary of State for ensuring that in that year we can herald a new beginning to electrification to Swansea bay city region, encouraging inward investment and growth? Will she assure me that a door will be opened for more investment in transport infrastructure, including ports and roads?

Justine Greening: I understand how important this investment is. I think that it was Admiral insurance that wrote to me saying what a difference the investment could make to jobs in the area. It was precisely those sorts of representations I reflected on, which is why I know that the investment will make a huge difference.

Andrew Murrison: I warmly welcome the statement. What will the Transport Secretary do to dispel the impression that the south-west is the poor country cousin of the railway network, which will of course be underscored by HS2 and the north-south electric spine? She will want to address particularly the plight of residents west of Salisbury.

Justine Greening: I am always keen to look particularly at what we can do to improve transport infrastructure in the south-west. There is an issue of resilience for the railway and road network, but my hon. Friend will remember that we announced the electrification of the Great Western railway line, and we have announced an intercity express programme that will result in more capacity on that line and the potential for more frequent services. Perhaps less close to him, in Bristol, we have announced today substantial investment in Bristol Temple Meads station. All those things will begin to strengthen the south-west transport system, but I would like to see what we can do to go further and do better.

Nigel Adams: My right hon. Friend the Minister of State, Department for Transport kindly met members of the Selby and district rail users group and me to discuss the electrification of the line from Micklefield to Selby. They will be delighted
	to hear that the scheme will go ahead. Will the Secretary of State confirm that that historic investment will contribute to the control of fare rises and will reduce overcrowding for my constituents in Selby?

Justine Greening: The Micklefield to Selby electrification opens up a second route to the north of Leeds, as my hon. Friend will be aware. It also means that potentially we can have three trains an hour serving London. He is right: electrification means that we have a lower-cost railway, which is the key to getting off the hook of having to pass on above-inflation rail-fare rises to passengers every year.

Andrew Bingham: I welcome the investment in line speed and capacity improvement on the links between Manchester and Sheffield. The Hope Valley line through my constituency provides a vital link for freight and passengers. Does my right hon. Friend agree that investment in that line will benefit not only the two great cities but many of my High Peak constituents?

Justine Greening: Yes it will. The more freight we can get off the road, the better. The more options we can give people to get off the road, the better.

Julian Huppert: I congratulate the Secretary of State and her team on this excellent announcement. In 13 years, the previous Government managed to electrify nine miles—a distance that a garden snail could cover in 15 days. They also allowed rail fares to go up by 66%. Does the Secretary of State agree that rail fares are too high, and that it is time to end above-inflation rail fare increases?

Justine Greening: I have to say that I did not know that snails were that fast, but I believe we need to try to get off this hook of above-inflation rail fare rises every year, which is one reason why we are looking at the efficiency savings programme that Roy McNulty first outlined. Today’s investment in electrification will be a key part of that as well.

Stephen Hammond: In my right hon. Friend’s time as Secretary of State, a new Victorian era of rail investment is not only being promised but delivered. Does she agree that removing some of the
	bottlenecks is key to capacity? Will she use some of the £700 million that is available so that users of the Wimbledon loop will gain the full benefits of Thameslink?

Justine Greening: I am sure that we will look closely at the case my hon. Friend has made. I know he has worked very hard, alongside other local MPs, to see local railway services improved. Wimbledon itself is a key railway hub for his local area. It plays a really important role, and I am keen to see what we can do to improve it.

Penny Mordaunt: I congratulate the Secretary of State on this announcement, and particularly the investment in the Portsmouth to London line and longer rail franchise agreements. If she will forgive my greed, will she consider writing into those new agreements basic passenger comfort standards, such as seat design and toilet provision, so we can ensure the quality and accessibility of these services?

Justine Greening: I have met my hon. Friend to discuss some of her concerns about the rolling stock used by some of her constituents on local lines. I take those points very seriously. That is why one of the pots of money we have set aside is to improve the passenger experience. It may seem like a small thing to have adequate toilet provision on trains, but for many people, particularly for mothers with kids, it is really important. My hon. Friend is therefore right to raise this point.

Robert Buckland: Businesses and residents in Swindon will warmly welcome the Government’s commitment to a new rail western access to Heathrow. Connectivity is the key. Will my right hon. Friend assure me that with the extension of electrification through to south Wales and Swansea, we will see electric-only rolling stock on the cross-country Great Western line?

Justine Greening: We will move to electrify the rolling stock, too. It is one way of ensuring that we keep operating costs down. My hon. Friend’s constituents could see a 30-minute reduction in their journey time to Heathrow. That will benefit not just his area but the whole of the south-west.

Several hon. Members: rose—

Lindsay Hoyle: Unfortunately, I am going to have to cut off debate on the statement now.

Points of Order

Kevan Jones: On a point of order, Mr Deputy Speaker. At Defence questions, the Secretary of State announced that he was going to lay a written ministerial statement tomorrow on the future of Defence Equipment and Support—the equipment arm of the Ministry of Defence. He said that a decision had been taken to run the organisation by a Government-owned, contractor-operated model. This decision has been the subject of debate, delay, review and speculation over the last two years. In the light of how important this matter is—not only to those working in the defence sector but to many Members—is it right for it to be announced through a written ministerial statement rather than an oral statement and on the last day before the House rises for the summer recess, as it denies us the opportunity to scrutinise this very important decision?

Lindsay Hoyle: The hon. Member has put his point on the record, and I am sure that the Secretary of State for Defence will be made aware of his comments.

Sharon Hodgson: On 4 July, the Under-Secretary of State for Education, the hon. Member for East Worthing and Shoreham (Tim Loughton), who has responsibility for children and young families, told me in a written answer that he was not aware of any individuals recruited to civil service positions in his Department who had previously been employed or elected in political positions. I am aware of at least three such appointments to senior positions— Janet Grauberg, Alexandra Gowlland and Elena Narozanski—and there may be more. I am certain that the Minister would not knowingly have misled the House, so I can only assume that he had not confirmed the accuracy of the answer he was given, despite the fact it took over a month to provide it. Mr Deputy Speaker, will you advise whether it is still the case that Ministers are responsible to Parliament for the accuracy of the information they give to it? What steps can be taken to ensure that the Minister comes to Parliament to correct the record?

Lindsay Hoyle: As the hon. Lady knows, the occupant of the Chair is not responsible for the answers that Ministers provide. She has nevertheless put her point on the record, and I am sure it will be taken up.

Opposition Day
	 — 
	[4th Allotted Day]

National Health Service

Andy Burnham: I beg to move
	That this House regrets the growing gap between Ministers’ statements and what is happening in the NHS; notes mounting evidence of rationing of treatments and services by cost, despite Ministers’ claims to have prevented it; further regrets the increasing number of cost-driven reconfigurations of hospital services, despite the Coalition Agreement’s promise of a moratorium on changes to hospital services; further notes growing private sector involvement in both the commissioning and provision of NHS services, contradicting Ministers’ claims that the NHS reorganisation would not increase levels of privatisation; recognises that, according to the Government’s Public Expenditure Statistical Analyses figures, actual Government spending on the NHS in 2011-12 fell by £26 million, the second successive real-terms reduction in NHS spending, following a reduction of £766 million in the Government’s first year in office, in breach of the commitment in the Coalition Agreement; believes the Government’s decision to reorganise the NHS has distracted its focus from the financial challenge, with seven out of 10 acute hospital trusts in England missing savings targets in the first half of 2011-12; calls on the Government to take action to prevent rationing by cost in the NHS, based on the evidence presented; and further calls on the Government to honour pledges on NHS spending in the Coalition Agreement, and the commitment that future savings will be reinvested into the NHS front line, and to return at least half of the underspend to the Department of Health budget.
	The year 2011 was the first full year of the coalition Government and the year of the biggest ever fall in public satisfaction with the national health service. As I shall set out, those two facts are not unconnected. The NHS in England is reeling from the Government’s catastrophic decision to reorganise it at a time of huge financial pressure. Warnings by Opposition Members and others during the passage of the Health and Social Care Act 2012 of a postcode lottery, of destabilised hospitals and of increasing privatisation are, sadly, beginning to materialise.
	For the coalition, attention has moved to other battles—more pressing priorities—but for the NHS the moment of greatest danger is now, as the unstoppable force of reorganisation hits the immovable object of the financial challenge. That is why the Opposition make no apology for introducing this debate, or for bringing the House’s attention back to where it should be: our country’s most important public service and the struggle it faces.
	I am grateful for the Secretary of State’s letter—[ Interruption. ] I can hear him mumbling away on the Government Front Bench. I would have thought the debate would justify his attention, as it justifies that of the Minister of State, the right hon. Member for Chelmsford (Mr Burns). The Opposition have introduced this debate to support NHS staff. We thank them for what they do. They have a huge capacity to deal with whatever is thrown at them, but they have been set mission impossible by the Government. One can only wonder how they felt on hearing the news that the Deputy Prime Minister had the chance to stop this reorganisation but chose to prioritise House of Lords reform. A million hearts will have sunk.
	It was not just the Government’s decision to reorganise that was wrong; the way they have gone about it was wrong as well.

Graham Stuart: The right hon. Gentleman will know that the Chair of the Public Accounts Committee said that productivity fell continuously for a decade under the previous Government. Does he regret that and recognise that radical change is required to get the productivity improvements this country desperately needs if we are to be able to afford the NHS we all want?

Andy Burnham: I am afraid the hon. Gentleman is out of date, because the figures cited by the Government are wrong. NHS productivity was improving by the time Labour left office. The independent and authoritative Commonwealth Fund pronounced the NHS the most efficient health care system in the world in June 2010. That was the legacy of the Labour Government, which the Conservative party is putting at risk.
	As I have said, it was not just the decision to reorganise that was wrong; the way the Government have gone about it is also wrong. Before the ink was dry on their White Paper, Ministers set about dismantling existing NHS structures before the new ones were in place. That is a dangerous move at any time, but disastrous at a moment of financial crisis.
	We have therefore had drift in the NHS: a loss of focus at local level and a loss of grip on the money just when it was most needed. At a stroke, the Government demoralised the very work force who would be crucial to managing the transition, with primary care trust managers dismissed as worthless. Experienced people left in droves. Those who stayed hoping for jobs in the new world were issued with scorched earth instructions: “Get on and do the unpopular stuff now—the rationing and the reconfiguration—so the new clinical commissioning groups don’t have to.”
	We can now see the consequences across England: brutal, cost-driven plans for hospital reconfiguration being railroaded through on an impossible timetable without adequate consultation; walk-in centres being closed left, right and centre; and people left in pain and discomfort, or facing charges for treatment, as PCTs introduce restrictions on 125 separate treatments and services.

Andy Slaughter: On the subject of brutal closures, did my right hon. Friend have a chance to look at the authoritative report by David Rose in The Mail On Sunday yesterday about the “Beeching-style” closure of major casualty units? Four out of nine of the units to be closed are in west London, leaving my constituents and 2 million people in west London without adequate health cover.

Andy Burnham: I have no idea how Ministers expect west London to cope with service reductions on that scale, nor do I know how they square them with the moratorium on hospital closures and changes which they promised at the last election. Perhaps we will hear some justification later today, although I will turn to reconfigurations shortly.

Stephen Pound: Further to the previous question, the hon. Member for Ealing Central and Acton (Angie Bray) has said that this is all about finance, and she may well be right. However, bearing in mind the fact that Ealing hospital not only came in under budget but produced an operating surplus last year, what possible justification can there be for ripping this crucial and much needed service from the heart of our community?

Andy Burnham: My hon. Friend makes his point powerfully. With some reconfigurations there is a clinical case supporting change, such as the changes I introduced in London before the last election to improve stroke services. We reduced the number of centres from 12 to eight. That was a difficult decision for many London Members at the time, but it was the right thing to do because lives are being saved. However, there is a world of difference between those changes and the crude, cost-driven reconfigurations in the NHS that those on the Government Benches said they would not allow.
	I spent my weekend reading a very entertaining book entitled “Never Again? The story of the Health and Social Care Act 2012: A study in coalition government and policy making”. It is a very interesting book and offers a new, detailed account, by Nick Timmins, of the Government’s NHS reorganisation—or, as it says on the blurb, the inside story of a “car crash”. I particularly enjoyed the quotation from the Minister of State—I gather that he has not read it, but there he is, up in lights at the very beginning of the book. He made this comment about the then Bill, which the author thought worthy of special attention:
	“You cannot encapsulate in one or two sentences the main thrust of this.”
	He should know that better than anybody, as he toured more media studios than anybody, and used more sentences than anyone, in a vain attempt to sell the technocratic and dense plans that made sense to his boss and nobody else.

Anne Main: Given that the biggest strain on most health authorities is staff pay, does the right hon. Gentleman regret the fact that Labour doubled the remuneration of GPs, allowing them to opt out and thus putting huge stresses on many health care authorities, which then had to buy in additional services? Does Labour not regret allowing doctors to be paid more for doing less?

Andy Burnham: I am interested in the argument that the hon. Lady is beginning to develop, which is that she wants to deliver pay cuts to NHS staff across her constituency. Presumably she wants the same as people in the south-west are getting. Is that what she is calling for? It is an interesting argument, and I would be interested to hear her expand on it later.

Barry Gardiner: Will my right hon. Friend give way?

Andy Burnham: In a moment.
	What I found most useful about the book is that it answered a question that has been nagging away in my mind for some time. As a former Health Secretary, I remember clearly the warnings I received from senior
	civil servants about the sheer scale of the £20 billion efficiency challenge. “It would be a major undertaking,” they said. “The NHS would need to focus all its energy on that alone. To be negotiated safely, new policy initiatives would have to be put on hold.” Over the months that have followed, I have often had cause to recall those words, as I watch the Secretary of State add to the financial challenge with the biggest ever reorganisation in NHS history. Did the same civil servants issue the same apocalyptic warnings to the incoming Secretary of State as they did to me? Finally I have my answer, in a quotation in the book from an unnamed senior civil servant:
	“The biggest challenge was trying to get the secretary of state to focus on the money—the £20 billion and the sheer scale of the financial challenge”.
	According to that civil servant, however, the Secretary of State’s attitude was:
	“I am going to do these reforms anyway, irrespective of whether there are any financial issues. I am not going to let the mere matter of the financial context stop me getting on with this”.
	Another civil servant is quoted as saying:
	“We did point out to him that his plans were written before the big financial challenge, and didn’t that change things? He completely did not see that at all. He completely ignored it”.
	Then the question is asked: was the Secretary of State presented by the Department with alternatives to inflicting legislative upheaval on the NHS? A senior civil servant said that
	“it was clear that having posed the question of did he want to see other options, that Andrew was not very interested at all in us presenting alternatives.”
	A picture is emerging of a Secretary of State with an inability to listen, take advice or heed warnings, who is going to have his Bill regardless of the upheaval that it will cause to the national health service.

Barry Gardiner: I am grateful to my right hon. Friend for giving way, although I fear that the moment might have passed. I simply wanted to ask him to reflect on the challenges that the hon. Member for St Albans (Mrs Main) issued to him about doctors and pay. Does he agree that those doctors are now the very people who are in charge of commissioning the services of which they are also the providers? I wonder whether the hon. Lady thinks that that is a good thing or a bad thing.

Andy Burnham: At the heart of the defective legislation that the Government rammed through the House of Commons is an unresolved conflict of interest, in which commissioners can also be providers who can remove services from hospitals and then provide them themselves. Under pressure in the other place, the Government came up with a requirement for a statement of such interests, but without introducing any mechanism for enforcement to ensure that decisions in the NHS are being made for the right reasons. I fear that that conflict of interest will return to haunt the Government.

Andrew George: The right hon. Gentleman knows that I share his critique of the Health and Social Care Act 2012. He mentioned the fact that civil servants had given him warnings and cautioned him about the consequences of his decisions during his time in office.
	Was he warned about the changes in regulations that have resulted in the decision of the south-west consortium to suggest changes to the terms and conditions and pay of staff in that area? That was a direct result of regulations brought in by his Government.

Andy Burnham: No, it was not. Agenda for Change was one of the proudest achievements of our Government, and we always staunchly defended national pay arrangements. The hon. Gentleman talks about warnings, but I have just read out the explicit warning that was given to the current Secretary of State that this was the wrong time to reorganise the NHS. It was unforgivable to proceed in those circumstances. This was the single most reckless gamble ever taken with the NHS, and patients and staff are already proving to be the biggest losers.

Steve Brine: I was not reading the book that the right hon. Gentleman has mentioned at the weekend, but I was listening to Radio 4 last night while I was doing the washing up, as I do. I heard one of his colleagues, the hon. Member for Wigan (Lisa Nandy), say that Labour was committed to repealing the Health and Social Care Act in its entirety. Will the shadow Secretary of State tell me whether, when I am in Winchester over the summer recess, I should tell the clinical commissioning groups that are getting on with their work that all that work would be undone, and that the Hampshire primary care trust and the South Central strategic health authority would be recreated if Labour were to form the next Government?

Lindsay Hoyle: Order. We are short of time, so may I request short interventions, please?

Andy Burnham: There is a simple answer: yes, we will repeal the Act. It is a defective, sub-optimal piece of legislation and it is saddling the NHS with a complicated mess. The hon. Gentleman should listen to the chair of the NHS Commissioning Board, whom his Secretary of State appointed. He has called the legislation “unintelligible”. In those circumstances, it would be irresponsible to leave it in place.

Stephen Dorrell: Will the right hon. Gentleman give way?

Andy Burnham: I will give way to the Chair of the Select Committee in a moment.
	Wherever we look, we see warnings of an NHS in increasing financial distress, yet according to Ministers everything is fine. The gap between their complacent statements and people’s real experience of the NHS gets wider every week. They are in denial about the effects of their reorganisation on the real world. That dangerous complacency cannot be allowed to continue.

Simon Burns: In the light of what the right hon. Gentleman has just said, will he clear up this confusion? His leader, the right hon. Member for Doncaster North (Edward Miliband), has said that he would keep clinical commissioning, yet the shadow Secretary of State has just said that he would repeal the Act in toto, which would include the provisions on clinical commissioning.

Andy Burnham: One of the great tragedies in this book is the Secretary of State’s admission, during a statement in the House in which he announced the “pause”, that he could have done most of what he wanted to do without legislation. The former Secretary of State, the right hon. Member for Charnwood (Mr Dorrell), is quoted as muttering to a colleague, “Why on earth are we doing it, then?” Well, why on earth did he do it? Because he wanted his Bill, regardless of other people.

Stephen Dorrell: A moment ago, the right hon. Gentleman told my hon. Friend the Member for Winchester (Steve Brine) that Labour was committed to repealing the Act in its entirety. Does that not mean that an incoming Labour Government would be committed to precisely the kind of pre-cooked reorganisation of which he has just accused my right hon. Friend the Secretary of State?

Andy Burnham: No, it does not. This is what Government Members do not understand. It is not about the organisations, but about the services that they provide. The existing organisations can be asked to work differently, and I would ask them to work differently. I do not want NHS organisations to be in outright competition, hospital versus hospital; I want them to work collaboratively. So yes, we will repeal the Act, but no, there will not be a pointless top-down reorganisation of the kind that we have seen the Secretary of State inflict on the NHS.
	This complacency is dangerous, and it cannot be allowed to continue. We had two clear purposes in initiating today’s debate. First, although we cannot stop the Government’s reorganisation, we can hold them to account for promises that they made to get their Bill through. I shall shortly identify five such promises in respect of which we are asking Ministers to live up to their words. Secondly, we wanted to give the House a chance to help the NHS by voting to hold the Government to account and enforcing the coalition agreement’s commitments on NHS spending.
	Let me first deal with Ministers’ claim that there is no evidence of rationing of treatments by cost. They have promised to act if any evidence is presented. In fact the evidence is plentiful, and it is simply not credible for Ministers to deny it. The postcode lottery of which we warned is now running riot through the NHS. We have identified 125 separate treatments that have been stopped or restricted in the past two years, in some cases in direct contradiction of guidance from the National Institute for Health and Clinical Excellence.

George Howarth: Last week I was at Whiston hospital, which, as my right hon. Friend will know, covers Knowsley and St Helens. The net effect of all the changes is that its staff, particularly the nursing staff, are thoroughly demoralised. Does my right hon. Friend accept that any commitment that he makes to changing the system will be welcomed by NHS staff?

Andy Burnham: I have heard the same from staff throughout the system. Morale has never been lower. People have been badly let down by a Government who promised them no top-down reorganisation, a moratorium on hospital changes, and real-terms increases. None of those things has been delivered. During the run-up to
	the general election the Conservatives cynically used the NHS to try to gain votes, and they will pay a heavy price for breaking the promises that they made then.

Simon Burns: rose—

Clive Efford: rose—

Andy Burnham: I will give way to the Minister one more time, and then to my hon. Friend the Member for Eltham (Clive Efford), but after that I must make some progress.

Simon Burns: I am grateful to the right hon. Gentleman. Although he did not answer the question that I asked him earlier, he did spread more confusion. If he were ever in a position to repeal the entire Act and did so, given that the strategic health authorities and the primary care trusts will have long since gone, how does he envisage care being commissioned for patients?

Andy Burnham: The Minister seems to equate removal of the Act with bringing back PCTs and SHAs. I do not have a problem with clinical commissioning, and I said as much during the Bill’s passage. I introduced it myself. I do not have a problem with clinical commissioning groups; my problem is with the job that they are asked to do, and the legal context in which they are asked to operate. We reject the Secretary of State’s market, and that is why we will repeal his Act.

Clive Efford: Clinicians in south-east London presented proposals for the reorganisation of our health care provision in “A picture of health”. It was all agreed by local commissioners, but when the Tories took office, they imposed a two-year delay that cost our health care trust £16 million a year—and that is the same trust that the Secretary of State has just put into administration.

Andy Burnham: This is what happened: when they came into government, they had a cynical policy of a moratorium, and they went up to Chase Farm hospital to announce it, saying, “There will be no cuts and no closures at this hospital.” They traded and touted for votes in that constituency for years on the back of that issue, and now that hospital is going to close. They delayed the reconfiguration and then they delayed the savings that came to the NHS. It was disgraceful, and people will have seen through it.

Dave Watts: I wish my right hon. Friend well in trying to hold this Government to account. The NHS is paying consultancy fees all around the country: hundreds of thousands of pounds are being wasted, and the Government are refusing to publish the information. They are also bullying many of the trusts. How are we going to get the information out when the Government are doing this?

Andy Burnham: My hon. Friend is absolutely right about the waste of money the Government have brought into the NHS through this reorganisation. The total is over £3 billion. That is simply unjustifiable at this time. Staff who had been working in primary care trusts are either being re-employed as consultants or are going
	into clinical commissioning groups. This is such a waste of money at a time when the NHS needed every penny to maintain standards of patient care.
	I was talking about rationing, and let me focus on cataract surgery. GP magazine has found limits on cataract surgery in 66% of PCTs. The Royal National Institute of Blind People found that 58% of PCTs are using visual acuity thresholds to restrict surgery. This is the evidence, so the Secretary of State had better start listening. What has happened since those restrictions on cataract operations have been introduced? Unsurprisingly, the number of cataract operations in England fell by over 12,000 between 2010 and 2011. That is a direct result of the new restrictions. There is no less need, however. Thousands of older people need such procedures, but they are now being forced to live with very poor sight.
	This is truly a false economy. Cataract surgery is one of the most cost-effective procedures carried out by the NHS. It helps people live independently and have a quality of life, and research has shown that in the last two years poor vision has been a factor in 270,000 falls by people aged 60 or over. This is the rationing by cost that Ministers have repeatedly denied is happening. So let me ask the Secretary of State again: does he agree with these restrictions on cataract surgery? If he does not, will he take immediate action to lift them?

Frank Dobson: Will my right hon. Friend confirm that under the last Labour Government the number of cataract operations carried out by the NHS rose from 160,000 a year to 310,000 a year, as a result of the commitment of the staff? What will the staff in the south-west think about all this if they have their pay cut?

Andy Burnham: For staff who are trying to hold things together through the chaos the Government have brought about, what a kick in the teeth it must have been to read in the Sunday newspapers that unless they accept pay cuts, they will be made redundant. My right hon. Friend says the staff made those improvements, but so did he. As the incoming Secretary of State, he made improvements to waiting times for cataract surgery, which, if I remember rightly, were commonly about a year in the late-1990s. We brought those waiting times right down. Now what do we hear? We hear that under this crowd people with two cataracts are being told, “You can have one done, but not both.” That is what the NHS has been reduced to under this Government. The Secretary of State has promised action, and I have given him the evidence. He now must take action.
	The second area on which the Government need to be challenged is privatisation. As the debate on the Bill drew to a close, the Secretary of State made this clear statement:
	“The legislation is absolutely clear that it does not lead to privatisation, it does not promote privatisation, it does not permit privatisation and it does not allow any increase in charges in the NHS.”—[Official Report, 27 March 2012; Vol. 542, c. 1335.]
	It is hard to know where to start, but how about the NHS walk-in centre in Sheffield, which is managed by a private company and has just started charging patients with whiplash injuries £25 for treatment, or the NHS
	hospitals now marketing private treatments for in vitro fertilisation, cancer screening or bone screening since the cap was lifted? How about the letter sent to all PCTs requiring them to identify three or more services for tendering under the “any qualified provider” measure in 2012-13? How about the 100 or so tenders for a range of services that have been offered to the private sector on this Secretary of State’s watch, with a total value of more than £4 billion? So let me ask the Minister and the Secretary of State today: will they now at least be honest about their true intentions for the level of private sector involvement in the NHS?

Sharon Hodgson: Is my right hon. Friend as concerned as I am about the exponential rise in the number of private health care ads that we see on our television screens and in our newspapers every day? These ads had almost disappeared under the previous Government. Advertisers advertise only when they know that there is a market.

Andy Burnham: This is really important; it is where all of what the Government are doing comes together. They have put in place restrictions in treatments— 125 separate treatments, as I have just mentioned— and at the same time they have given a 49% cap to NHS hospitals to do more private work. So as the NHS decommissions services, hospitals are then free to start offering those services. That is why my hon. Friend is beginning to see the changes that she is noticing, and this is the clear agenda of the Conservative party.

Huw Irranca-Davies: Does not the fragmentation that my right hon. Friend is describing raise the crucial question about when the national health service ceases being a national health service under this Government?

Andy Burnham: The Bill that the Government brought through is an attack on the N in the NHS; that is what it was designed to do. It was designed to break national standards; to break national pay; to break waiting time standards; and to allow primary care trusts to introduce random rationing across the system. That was the intention of the Bill that they brought through; they wanted an unfettered market in the health service, and my hon. Friend is absolutely right. That is why we are saying that we will repeal this Act and restore the N in NHS at the earliest opportunity.

Andrew Percy: On 28 June, in response to misinformation put out by Labour councillors, the medical director of my local hospital trust, a doctor of 30 years, wrote an article in my local paper under the headline “NHS faces greatest challenge”. She talked about staff costs, treatment costs and the 2008 Nicholson challenge. She said that the trust’s problems date “back to 2008”, and she continued:
	“Having been a doctor for nearly 30 years, the 2008 Nicholson challenge is, by far, the greatest challenge the NHS has ever faced”.
	What should we believe: the picture being presented by the right hon. Gentleman or this article?

Andy Burnham: The hon. Gentleman is making my point; if he was listening to what I said at the start of my speech, he would have heard me say clearly that
	the £20 billion Nicholson challenge, which I set, was always going to be a mountain to climb for the NHS. Let us be clear that it was. What was unforgiveable was combining that Nicholson challenge with the biggest ever top-down reorganisation in history, when the whole thing was turned upside down, managers were being moved or made redundant and nobody was in charge of the money. That was what was so wrong, and that is what the hon. Gentleman should not be defending if he is defending staff in the NHS.
	The third area where we need action from Ministers is on protection for staff. The Deputy Prime Minister said recently:
	“There is going to be no regional pay system. That is not going to happen.”
	But we heard yesterday that a breakaway group of 19 NHS trusts in the south-west has joined together to drive through regional pay, in open defiance of the Deputy Prime Minister. They are looking at changes to force staff to take a pay cut of 5%; to end overtime payments for working nights, weekends and bank holidays; to reduce holiday time; and to introduce longer shifts. We even hear that if staff will not accept this, they are going to be made redundant and re-employed on the new terms. So let us ask the Secretary of State and the Minister to answer this today: do the Government support regional pay in the NHS and the other moves planned by trusts in the south-west? If they do not, will they today send a clear message to NHS staff in the south-west that they are prepared to overrule NHS managers?
	Fourthly, I shall deal with reconfigurations. The House will recall the promise of a moratorium on changes to hospitals and the Prime Minister’s threat of a “bare-knuckle fight” to resist closure plans. In 2010, the Secretary of State set out four tests that all proposed reconfigurations had to pass. They related to support from general practitioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice. He said:
	“Without all those elements, reconfigurations cannot proceed.”
	So let me ask the Minister: does he think that the A and E units closing at Ealing, Hammersmith, Charing Cross and Central Middlesex pass that test? How about St Helier, King George, Newark and Rugby? Is it not clear to everyone that the Prime Minister’s bare-knuckle fight never materialised? Is it not also clear that no one told the Foreign Secretary, the Work and Pensions Secretary or even the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is responsible for care and older people and who has launched a campaign against his own Department? What clearer sign could there be of the chaos in the Department of Health and of the chaos engulfing the NHS? Will the Secretary of State now take action to stop reconfigurations on the grounds of cost alone?
	That brings me to my fifth and final area for action, which is NHS spending. The coalition agreement said:
	“We will guarantee that health spending increases in real terms in each year of the Parliament.”
	That is health spending, not the health allocation. Official Government figures show that actual spending has fallen for two years running and the underspend has been clawed back by the Treasury. Of all the promises the coalition has broken, people will surely find that one
	the hardest to understand given that the Prime Minister appeared on every billboard in the land, on practically every street in the land, promising to do the opposite just two years ago.

Gordon Birtwistle: Will the right hon. Gentleman advise me who he consulted with before he closed the A and E unit in Burnley?

Andy Burnham: I was prepared to make difficult decisions and be honest about them. I am not proposing the reversal of that decision and I note that clinicians in his area recently said how it had improved outcomes for his constituents. What I will not do—what I will never do—is go to marginal constituencies, as the Secretary of State did, and make false promises that I will reopen such units. The Secretary of State did that before the last election; no wonder he is looking shifty in his seat right now. He went to the hon. Gentleman’s constituency and said that he would reopen that unit. Has he done that? I do not believe that he has.

Clive Efford: On that very point about turning up in constituencies just before general elections promising to save A and E services, the Tories pledged to save 999 services at my local hospital, Queen Mary’s, Sidcup. They pledged to keep that A and E open—the Secretary of State did so himself. Where is the A and E?

Andy Burnham: I do not know how the Secretary of State justifies what has been done. Even in my own patch, Greater Manchester was going through a children’s and maternity services review and some constituencies were benefiting from the changes—Bolton, for example, was getting a bigger maternity unit—but some were not and this Secretary of State went both to Bury, where he said that he would defend the maternity unit, and to Bolton, for a photo call celebrating the new investment. If anything illustrates the sheer opportunism of the Secretary of State in opposition, surely that is the example that does.

Several hon. Members: rose —

Andy Burnham: I will give way to the hon. Member for Totnes (Dr Wollaston) before I conclude.

Sarah Wollaston: I hope that in his conclusion, the right hon. Gentleman will address a point raised by the King’s Fund. It said that the greatest policy failure of the previous Administration was the failure to tackle health inequalities. He says that he wishes to repeal the whole of the Health and Social Care Act 2012, but does he accept that shifting public health back to local authorities gives us one of the greatest opportunities to tackle health inequalities? Will he seriously put public health back where it was before and, by so doing, continue to fail to address health inequalities?

Andy Burnham: The hon. Lady mentions the Act, and I seem to remember that she called the Bill a hand grenade thrown into the health service. She seems to have changed her tune since then. We made huge progress on tackling smoking and improving the public health of this country, progress of which we are very proud. We can always say that we could have done more, but
	I remember putting through measures on smoking towards the end of our time in government that were opposed by those on the Government Front Bench. I am not sure how she could justify that.
	The budget cut combined with the distraction of reorganisation means that six out of 10 hospitals in England are now off target for their efficiency savings. That brings me back to where we started: this is the wrong time to reorganise the national health service. In conclusion, the House cannot reverse tonight the damage of the NHS re-organisation, but we are not powerless. There are things we can do to help the NHS at one of the most dangerous moments it has faced. Our constituents will expect us to hold Ministers to account for promises made on rationing and reconfigurations. They will want us to do the right thing by NHS staff facing pay cuts and redundancy. Our constituents have a right to expect that one of the central pledges in the coalition agreement—not to cut the NHS—will be honoured. That is the simple call of our motion this evening which, we hope, can unite all sides of the House. A vote tonight for the motion would be a positive vote for an NHS under siege and a message of appreciation for NHS staff facing uncertain times. I commend the motion to the House.

Simon Burns: The motion that we are debating today is typical of the Opposition. Rather than praising the NHS in a year of change, they seek to denigrate it. Rather than commending the hard work and dedication of NHS staff, they undermine their efforts and belittle their results. Rather than supporting the parts of the NHS that are dealing with long-term financial challenges—challenges that were partly of the own making of the right hon. Member for Leigh (Andy Burnham)—they attempt to scaremonger.
	In truth, this has been a year that has tested the NHS, which has dealt with significant financial pressures as well as the transition to the new system, but it is also a year in which the NHS has proven its mettle. Far from the meltdown that some gleefully predicted, we have seen a robust and resilient NHS delivering better care for patients.

George Howarth: Will the Minister give way?

Simon Burns: In a minute.
	I know that waiting times mean a great deal to the right hon. Member for Leigh, so let us have a look at the numbers. Despite what he peddles around the country, waiting times remain low and stable—in fact, below where they were at the last general election. In May 2010 more than 18,000 people waited more than a year for treatment. Today that figure is just 4,317. Today 55,335 people wait more than six months for treatment—almost half the figure of 100,979 at the last general election. There are 149,912 people now waiting more than 18 weeks, compared to 209,411 in May 2010. The median wait for admitted patients has fallen in that time from 8.4 weeks to 8 weeks, and for non-admitted patients from 4.3 weeks to 4 weeks. Across the country, all NHS waiting time standards for diagnostic tests and cancer treatment have been met.

Andy Slaughter: The Minister talks about scaremongering. For seven years my constituents put up with scaremongering from his party that Charing Cross hospital was going to close. The services there expanded. After two years of his Government, the hospital, 500 beds, and the accident and emergency department are closing and being replaced by an urgent care centre, which will treat only minor injuries. What will that do to his statistics?

Simon Burns: I am slightly surprised that the hon. Gentleman made that intervention because it rather proves my point about scaremongering. He said that is going to happen. The truth is that the local NHS has determined locally what it believes is the best reconfiguration of services. That is going out to public consultation and so far no decisions have been taken because the consultation process has only just started. It will last for 14 weeks and then the results of that consultation will be considered.

Several hon. Members: rose —

Simon Burns: I will now make progress.
	To return to waiting times and the record as a fact, rather than the fiction that Opposition politicians like to peddle, 96% of patients wait for fewer than four hours in accident and emergency, and every ambulance trust in England meets its core response times.

Andy Burnham: On accident and emergency waiting times, let us be clear. In the 2013 year to date, has the NHS met the 95% target or not?

Simon Burns: Yes; 96% of patients wait for fewer than four hours in A and E, and as the right hon. Gentleman knows, the percentile is 95%.

George Howarth: rose—

Valerie Vaz: rose—

Simon Burns: I shall make a little more progress.
	Let us not stop at waiting times. The £600 million cancer drugs fund that has helped more than 12,500 patients to access the drugs previously denied to them, the screening programmes for breast and bowel cancer, potentially saving an extra 1,100 lives every year by 2015, the world-leading telehealth and telecare whole systems demonstrator programme, which saw a stunning 45% fall in mortality and is set to transform of 3 million people with long-term conditions over the next five years—

Several hon. Members: rose —

Simon Burns: I will give way to my hon. Friend the Member for Crawley (Henry Smith), then I will give way to the right hon. Member for Knowsley (Mr Howarth) and the hon. Member for Walsall South (Valerie Vaz), then I will stop giving way for a time to make progress.

Henry Smith: Earlier this year I was delighted to be able to open a new digital mammography unit at Crawley hospital, a hospital which under the previous Government saw its accident and emergency unit closed down. Does my right hon. Friend find it
	odd that the Opposition refuse to match the spending commitments on the NHS that this Government are delivering?

Simon Burns: My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.

Valerie Vaz: The Minister is very fond of statistics. Can he say whether GP referrals have gone up, and whether A and E admissions have gone up or down?

Simon Burns: The hon. Lady will know that GP referrals have gone down slightly, but the referrals to A and E have risen slightly.

George Howarth: The Minister said in his opening remarks that Opposition Members are denigrating NHS staff and their achievements. Does he accept that if he has any conversations with NHS staff, he will find the reverse—they feel that they are being denigrated by this Government and their reforms?

Simon Burns: I do not like to contradict the right hon. Gentleman, but I will. What I said was slightly different from what he accused me of saying. What I said was that rather than praising the NHS in a year of change, the Opposition denigrate it. That is slightly different.
	To pick up on a point that the right hon. Member for Leigh mentioned from a sedentary position, GP referrals for 2011-12 were 1% lower than in the previous year, but outpatient referrals were, as I said, slightly higher.

Andrew Percy: Will my right hon. Friend give way?

Simon Burns: If my hon. Friend will allow me, I would like to make some progress. If the opportunity arises, I will give way to him then.
	I could stop after reporting all that good news, but I do not see why I should when there is so much more to praise the NHS for. It gets little praise for its performance from the Opposition. I want to praise the fact that patients are reporting better outcomes for hip and knee replacements and for hernias, and the fact that the latest GP patient survey showed that 88% of patients rated their GP practice as good or very good. MORI’s independent public perceptions of the NHS survey shows satisfaction with the NHS remaining high at 70%.
	In the patient experience survey, 92% of patients who had used the NHS in the past year rated their care as good, very good or excellent. Mixed-sex accommodation breaches are down an incredible 96% since we came to power, although of course the Opposition often claimed to have eradicated that problem—not so, alas. MRSA infections are down 24% in the year, and C. difficile infections down 17%. More than a million more people have an NHS dentist. No reasonable person could look at the performance of the NHS over what has been a challenging year with anything but admiration and
	pride. I, too, would like to take this opportunity to praise NHS staff for their hard work and dedication and the excellent results they are delivering for patients.

Angie Bray: Will my right hon. Friend give way?

Simon Burns: I promised to give way to my hon. Friend the Member for Brigg and Goole (Andrew Percy).

Andrew Percy: Will the Minister condemn Labour party representatives in Goole who, despite the fact that under Labour we saw ward closures and mental health in-patient beds go, recently gave the media incorrect waiting list times, and will he confirm that in north Lincolnshire 93% of patients are seen within 18 weeks, which is far ahead of the national target? The Labour party needs to stop talking down our local hospital.

Simon Burns: I am extremely grateful to my hon. Friend and certainly condemn any misrepresentation, misinformation or talking down of the NHS in any of my hon. Friends’ constituencies.

Several hon. Members: rose —

Simon Burns: If hon. Gentlemen and Ladies will bear with me, I would like to make some progress, because this is a short debate and many hon. Members would like to participate, but I will give way later.
	The motion, like the right hon. Member for Leigh, mentions a fall in spending on the NHS of £26 million in 2011-12. I will give him one statistic: £12.5 billion. There will be £12.5 billion extra for the NHS in this Parliament, £12.5 billion that would never have been made available had he had his way, as he said that to do so would be irresponsible. That is exactly what his party is doing in Wales, where it is in control of the NHS. It is cutting the NHS budget in Wales by 6.5% in real terms from 2011-12 to 2014-15. His motion talks about a £26 million underspend, but what he does not understand is that there has been a real-terms increase in funding for the NHS this year. Because we are no longer wasting hundreds of millions of pounds on a bloated bureaucracy and the national programme for IT, we have been able to save an extra £1.1 billion in real terms from the back office and put it into front-line care.

Andy Burnham: So that there is no confusion, because this is a very important matter, I will quote from a Department of Health press release of Friday 6 July:
	“PESA figures released today show that in real terms NHS spending has reduced slightly by 0.02%.”
	For the record, will the Minister say whether NHS spending rose or fell over the last financial year?

Simon Burns: What I was saying that the right hon. Gentleman—[ Interruption. ] He must wait one minute, because I will answer him. What I said, which is correct, is that, in keeping with our commitments, we have increased funding on the NHS in real terms—

Andy Burnham: It is your press release.

Simon Burns: Just wait. But, as he has said, and as I have said about the £26 million—[ Interruption. ]—there was an underspend in the NHS and that money, as he will know, because of the financial arrangements his party put in place for the NHS in 2004, will be ploughed back into the NHS over the next three or four years as extra spending. We will put in more money for front-line clinical staff, including more than 4,000 doctors—more money for doctors and treatments and for improving patient outcomes. Spending on front-line NHS services has increased by £3.4 billion in cash terms, or 3.5%, compared to last year.

Angie Bray: Will my right hon. Friend give way?

Simon Burns: Not at the moment.
	The motion states that seven out of every 10 acute hospital trusts in England missed their savings targets for the first half of 2011-12, referring to their cost improvement plans. Not only did the right hon. Gentleman use out-of-date figures—figures for the whole year are now available—but he again misrepresented what they mean for the performance of the NHS. Across the NHS, acute NHS trusts plan to save £1.3 billion during 2011-12. In the end, they saved £1.2 billion. More than half—57%—of the shortfall was concentrated in just 10 NHS trusts in significant financial difficulties— 10 NHS trusts that he ignored when he was Health Secretary but that we are getting to grips with. I would point him instead to the £4.3 billion of efficiency savings made in 2010-11 and the further £5.8 billion of efficiency savings made in 2011-12. Primary care trusts and strategic health authorities have reported a surplus of £1.6 billion in 2011-12, money that is being carried forward and made available for 2012-13 and thereafter.

Tom Blenkinsop: Will the Minister give way?

Simon Burns: No, I will not.
	Unlike the right hon. Member for Leigh, who championed cuts to the NHS, this Government are investing more in the NHS, more in front-line care, more in staff and more in treatments.

Angie Bray: As my right hon. Friend is aware, the proposal is to downgrade four accident and emergency departments across London that are all right beside my constituency. Does he agree with my constituents that losing four accident and emergency departments is disproportionate and will mean a significant loss of service for them locally?

Simon Burns: What I will say to my hon. Friend is similar to what I said to the hon. Member for Hammersmith (Mr Slaughter): that is a reconfiguration that is in progress and has been put together locally by the local NHS. It has just gone out to consultation and, obviously, when the process is complete the responses will be considered before any final decisions are made on the best way to provide care for her constituents and those of Opposition Members so that they can get the quality of care and the relevant care in their area. At the moment, when there is a consultation process going on, it would wrong of me to comment on a local decision,
	but I certainly urge my hon. Friend, her constituents and others to get involved in the consultation so that all views can be considered.

Several hon. Members: rose —

Simon Burns: I will now make some progress.
	The motion seeks to give the impression that NHS care is being rationed. That is worse than inaccurate: it is scurrilous nonsense and scaremongering on a grand and somewhat desperate scale. [ Interruption. ] I will come to cataracts in a moment. We did some rudimentary checking of our own into the veracity of those claims, which were originally made as part of the Labour party’s NHS health check. It was not long before it became abundantly clear that that was not worth the press notice it was printed on. It claimed that there was a blanket ban by NHS Hull on the removal of risk ganglia. We spoke with NHS Hull and found that there is no such ban. It claimed that 11 out of 100 PCT clinical commissioning groups restrict laser revision surgery for scars, but such cosmetic surgery has never been routinely available on the NHS, under either this Government or the previous Government, when the right hon. Member for Leigh was Secretary of State. It claimed that weight-loss treatment is restricted, stating that
	“patients generally have to be over 18 and have a BMI over a certain level to receive weight loss surgery”.
	Amazing—people actually have to be overweight to be entitled to weight-loss surgery. I would have thought that that was startlingly obvious, but obviously the right hon. Gentleman does not think so.

Andy Burnham: rose —

Graham Stuart: rose—

Simon Burns: I will give way to the right hon. Gentleman and then to my hon. Friend, but then I will make some progress.

Andy Burnham: Is the Minister aware that the National Institute for Health and Clinical Excellence guidance recommends that bariatric surgery should be offered only to people with a BMI of 40? Is he also aware that numerous PCTs all over the country are restricting access to that surgery by introducing their own arbitrary limits? That is evidence of the rationing I am talking about. He will know that the NHS constitution guarantees people access to NICE-approved treatments, so why does he not take action on those PCTs that are standing outwith the NICE guidance?

Simon Burns: What the right hon. Gentleman rather cunningly does not mention—[ Interruption. ] I am answering the question, if the hon. Member for Copeland (Mr Reed) can just keep quiet for a second. The right hon. Gentleman says that the NICE guideline refers to a BMI of 40, and that is absolutely correct, but I point him in the direction of one area in central London that does not go by that guideline, because it uses a BMI of 35, which is lower.

Graham Stuart: Is my right hon. Friend as confused as I am by the Labour party’s policy? The right hon. Member for Leigh (Andy Burnham) could not explain
	where public health would go; he wants to repeal the Health and Social Care Act 2012, although he wants the services to be shaped as the Act says; and on funding he said in June 2010:
	“It is irresponsible to increase NHS spending in real terms”.
	That is the Labour party’s policy: it is chaotic and makes no sense. Can my right hon. Friend please tell us whether he sees more sense in it than I do?

Simon Burns: I am afraid that I cannot help my hon. Friend, because the policy is contradictory and does not make sense.
	The right hon. Gentleman talks about repealing the 2012 Act, which includes the clinical commissioning groups, but if he abolishes them there will be no other mechanism from 1 April next year to commission care for patients, so there will be no one available to commission care for patients, which seems stunning.
	The right hon. Gentleman talks about funding, and his quotations—my hon. Friend the Member for Beverley and Holderness (Mr Stuart) mentions one—are quite clear: he disapproves of giving real-terms increases in funding to the NHS. In Wales, the Welsh Labour Government have taken him at his word and are cutting spending, which we are not very enthralled by.

Several hon. Members: rose —

Simon Burns: I will now make progress.
	Treatments available on the NHS are based on clinical need. There should never be any arbitrary rationing based on cost either locally or nationally—[ Interruption. ] The right hon. Member for Leigh shouts from a sedentary position, “There is”, and waves a piece of paper a little like Chamberlain on his way back from Munich, but if the piece of paper that the right hon. Gentleman is waving is his NHS health check, which officials in my Department have looked at, it is as worthless as the piece of paper that Chamberlain brought back from Munich.
	If the right hon. Gentleman has any genuine evidence based on the cost of care, I and the Department of Health will certainly investigate it. Such practices are totally unacceptable, and we will take them very seriously indeed, but until then, although the motion talks about “the evidence presented”, the truth is that there is none.
	The right hon. Gentleman claims that the number of cataract operations has fallen significantly since we came to power, but the reason for the fall is that clinicians have advised that the surgery is inappropriate in many cases—on clinical grounds. Surgery is available, however, for those patients who are clinically eligible, and they will receive it when there is a clinical reason.

Barbara Keeley: Will the Minister give way?

Simon Burns: No, I am making progress.
	The motion notes the growing involvement of the private sector, insisting that it represents evidence of growing privatisation. Not only is that unadulterated tosh, but I personally find it offensive to be accused of seeking to privatise the NHS, when in my political philosophy one of my core beliefs is in an NHS free at the point of use for all those eligible to use it.
	Not only does the right hon. Gentleman have some difficulty understanding the meaning of “privatisation”, but he forgets his own record in government. The only plan to increase the private provision of NHS services came under the previous Government when he was Minister, when his hon. Friend the Member for Leicester West (Liz Kendall) was the special adviser and when Patricia Hewitt was Health Secretary. In May 2007, the right hon. Gentleman said:
	“Now the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”
	Those are his words. It was his Government who saw private companies paid 11% more than NHS providers for doing the same work, and who wasted £297 million on operations that never happened at independent sector treatment centres. Given that he may have forgotten, I must tell him that the Labour party manifesto in 2010, when he was the Secretary of State for Health, stated:
	“Foundation trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services—where these are consistent with NHS values”.
	That suggests that, as Secretary of State, he was prepared to have in his own party’s manifesto a policy allowing and encouraging foundation trusts to attract more work from the private sector.
	This Government’s Health and Social Care Act 2012 specifically prohibits the Secretary of State, Monitor or the NHS Commissioning Board from favouring any type of provider, be they from the NHS, the charitable sector or the independent sector. It does so because this Government understand something that the right hon. Gentleman’s never did—it is not the nature of the provider, but the quality of the outcomes that matters most to patients.

Kate Green: Will the Minister give way?

Simon Burns: No, I will not.
	The motion speaks of the
	“increasing number of cost-driven reconfigurations of hospital services”.
	The reconfiguration of NHS services must always be led by a desire to improve patient care and patient outcomes. As lifestyles change, as needs and expectations grow and as technology develops, the NHS must respond. This Government are very clear that the reconfiguration of services is a matter for the local NHS, and that the best decisions are those taken closest to the front line and tailored to the needs of the local population. But, when making those decisions, it is imperative that the NHS carries the support of local people, patients, carers and clinicians.
	The principle is enshrined in the four tests that my right hon. Friend the Secretary of State set out in 2010: all local reconfiguration plans must demonstrate support from clinical commissioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice.

Clive Efford: rose —

John Woodcock: rose —

Simon Burns: The right hon. Member for Leigh equates the coalition agreement’s promise of a temporary moratorium on changes to hospital services, with a commitment to hold the NHS in a permanent state of suspended animation. The moratorium was needed to put a stop to the arbitrary reconfigurations that his Government instigated—reconfigurations that lacked the support of local clinicians, lacked a clinical evidence base and lacked basic democratic legitimacy. This Government and the Secretary of State have put that right.
	Now I turn to another issue that the right hon. Gentleman raised and which is of considerable importance, given what has—

Clive Efford: rose —

John Woodcock: rose—

Lindsay Hoyle: Order. Hon. Gentlemen, the Minister has given way quite a bit, and I am sure that if he wishes to give way he will let you know. You do not need to keep standing and hovering for so long.

Simon Burns: Thank you, Mr Deputy Speaker. Because I want to make progress so that other people can contribute, I will not accept any more interventions.
	On the South West Pay Consortium—[ Interruption ] —an issue on which I hope the right hon. Member for Leigh will listen, given that during his speech he seemed keen to hear the Government’s response—the Government’s position is clear: it is for employers, not for the Government, to lead negotiations on the terms and conditions of their staff, and to do so with the agreement of staff.
	This Government are committed to the principles of “Agenda for Change”, a national framework. The ongoing negotiations on “Agenda for Change” are about ensuring that patients and taxpayers get the maximum value for money from every penny spent on the NHS, and that it is spent efficiently and effectively. The negotiations are not about a pay cut, and we would not support one.
	The Health Act 2006, brought in by the previous Government when the right hon. Gentleman was the Minister of State in the Department of Health, gives NHS trusts the power to set their own terms and conditions. Although they are free to opt out of the national pay framework, they cannot do so unilaterally; they must consult and seek agreement with their staff and representatives.
	Almost all trusts have until now chosen to stay on national terms and conditions. I believe that most still want to, but that has to be fit for purpose and fit for the future. Only one trust—Southend—has opted out of “Agenda for Change”. [Interruption.] The hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) may be a Whip, but he is rather foolish to fall into the trap that I have just set. That trust opted out of “Agenda for Change” under the last Labour Government. Perhaps he would like to apologise.
	Pay is the largest element of NHS costs, and pay systems must evolve. The trusts in the south-west wish to work and negotiate with the trade unions to agree changes, not to dismiss and re-engage staff.

Kerry McCarthy: rose—

Simon Burns: The hon. Lady only recently walked in. She has not been here from the beginning.
	I call on the unions to respond positively to the issue and the national discussions on “Agenda for Change”. I also hope that the Opposition will support the policies that they put in place when in government.
	The Opposition have used this debate to make yet another sorry attempt to paint a distorted picture of the NHS. That is wrong. The shadow Secretary of State pours scorn on the performance of the NHS, while we admire the excellence of the staff; he belittles their achievement while we laud them; he scaremongers, while we present the truth more transparently than at any other time in the history of the NHS.
	The accusations in the motion are simply wrong, and I ask my right hon. and hon. Friends to join me in the Division Lobby at the end of the debate to defeat the motion.

Several hon. Members: rose —

Lindsay Hoyle: Order. I inform hon. Members that there is now a five-minute limit on speeches.

Grahame Morris: Thank you for calling me early, Mr Deputy Speaker. I am delighted to be able to participate in this important debate just before the recess.
	I refer hon. Members to part of the Opposition motion:
	“That this House regrets the growing gap between Ministers’ statements and what is happening in the NHS; notes mounting evidence of rationing of treatments and services by cost, despite Ministers’ claims to have prevented it”.
	I would like to highlight one specific example. The Minister, who is not paying attention at the moment, may wish to make note of the issue, because it matters to cancer patients in my area and across the country. I am talking about the lack of access to advanced radiotherapy.
	By way of background, I should say that the national cancer action team told NHS commissioners that radiotherapy is involved in 40% of cases in which cancer is cured. Furthermore, radiotherapy by itself now cures 16% of cancer patients. By contrast, cancer drugs are the main cure of only 2% of cancer patients. We can draw the conclusion that I hope the Department of Health and Ministers would accept: radiotherapy cures far more cancer patients than drugs. They should issue instructions to commissioners to reflect that and make money available for radiotherapy.
	The current allocations are inadequate and arguably paltry. The radiotherapy budget for the current year is just £350 million, while the cancer drug budget is close to £1.5 billion. Within that sits the Government’s flagship cancer drugs fund, which, according to information that I have received, was underspent by £150 million. Despite that underspend, an additional £200 million is going into the cancer drugs fund. My concern is that that money is not for cancer patients but for cancer drug companies.
	The whole idea is becoming discredited—so much so that, as has been reported in the newspapers, even Mr Clive Stone, the Prime Minister’s constituent who originally inspired the fund, has asked for less money to be put into the fund. Why? He now needs advanced radiotherapy for his cancer and there is no money available for him.
	The cancer drugs fund cannot be used to fund advanced radiotherapy, and that is a real concern. I have no doubt that during the winding-up speeches we will be told that the Government are putting in an extra £150 million into new radiotherapy treatments over the next four years. The Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow), keeps telling us that, but when I ask him where the first and second year allocations—£13 million and £22 million—are being spent, he tells us that he does not know.
	I thought I would try to help out the Minister, so I sent freedom of information requests to every strategic health authority asking how much of the money they had received and how their PCTs had spent it. I have good news for the Minister, who is not in his place. It is that he is not the only one who is in the dark when it comes to that £13 million and £22 million; the SHAs do not know either. I have the replies with me. I was going to read them out, but unfortunately I do not have time.
	The stark truth is that under this Government no new money is going into providing the latest radiotherapy technologies for the NHS. In March last year, the Secretary of State commended some of the new facilities, including the new CyberKnife system at St Bartholomew’s hospital in London. Members, some of whom have also been to see the system, are concerned that charities are having to be used to raise money to buy that vital equipment. When I raised that issue in this Chamber, the Minister disputed that, but I have furnished him with a list of areas where it is happening. The Minister should accept his responsibility, get a grip on the situation and ensure that cancer patients needing advanced radiotherapy have access to the service that they need. I support the motion.

Stephen Dorrell: It is a pleasure to follow the hon. Member for Easington (Grahame M. Morris), who is a member of the Health Committee. I hope he will forgive me if I do not follow him down the specialist course of radiotherapy services.
	I want to address my remarks primarily to the shadow Health Secretary and to begin with an echo from a different era. When I first came to the House, there used to be something called “Whitelaw’s law”, which, obviously, referred to the late Willie Whitelaw. “The more he blusters,” we used to say, “the less he believes it.” The shadow Health Secretary gave us an Olympic-class demonstration of the principle of Whitelaw’s law. He blustered from the Dispatch Box and got himself into several dead ends. It became clear that he did not really believe that he had answers for the challenges facing the NHS.
	I refer the right hon. Gentleman to a point that he made and which I agree with. The most important statement about the current state of the health service was not made by him as Secretary of State—and, with great respect to my right hon. Friend the Secretary of State, it was not made by him either. It was made by
	Sir David Nicholson in his annual report to the national health service in May 2009, and it was endorsed by the right hon. Gentleman. Sir David said, looking forward to the period of this Parliament:
	“we must be prepared for a range of scenarios, including the possibility that investment will be frozen for a time. We should also plan on the assumption that we will need to release unprecedented levels of efficiency savings between 2011 and 2014—between £15 billion and £20 billion across the service over the three years.”
	I agreed with what the shadow Secretary of State said about the importance of what we, in the Health Committee, dubbed “the Nicholson challenge”. I believe that that is the central challenge facing the national health service. The sadness in this debate was that the right hon. Gentleman gave us no hint as to how he believes the health service should address that central challenge about which he and I agree.

Graham Stuart: Meeting that challenge, and dealing with the challenges in the NHS generally, would be all the more difficult if one believed, as the right hon. Member for Leigh (Andy Burnham) does, that real-terms increases in investment in the NHS are irresponsible.

Stephen Dorrell: I agree with my hon. Friend, but let us not go down that route. At the time when Sir David Nicholson was writing, the Labour Government were contemplating the possibility not of a real-terms freeze, which is in effect what is planned under the coalition, but of a cash freeze, which would have been substantially more difficult to achieve.
	The main issue now is how we deliver services that meet the demands placed on the system against the background of a resource allocation to the health service that was always going to be dramatically less generous than it was during the earlier years of the Labour Government. We heard from the right hon. Gentleman a commitment that an incoming Labour Government would go through a clean-sheet-of-paper redrawing of the map—

Andy Burnham: indicated  dissent .

Stephen Dorrell: The right hon. Gentleman shakes his head, but he said that he would repeal the Health and Social Care Act 2012, the result of which would be to commit the health service to precisely the kind of reorganisation—or re-disorganisation—that he accuses the Government of introducing.
	The challenge for the Opposition is to show that they are willing to map a future for the health service, in much more constrained financial circumstances, that allows it to meet the demand for services that is going to be placed on it and to fulfil the aspirations that we all have for improved quality of service. That becomes increasingly difficult in the light of motions such as the one that the right hon. Gentleman has put down for the House to consider. He invites us to regret
	“the increasing number of cost-driven reconfigurations of hospital services”
	and
	“growing private sector involvement in both the commissioning and provision of NHS services”.
	Yet when he was Secretary of State and bore my right hon. Friend’s responsibilities for meeting this challenge, he made it clear that service reconfiguration was precisely
	how the health service needed to meet the challenges that it faced, and that the private sector had an important role—of course, not an exclusive role—in introducing the solutions to the challenge that Sir David Nicholson articulated in May 2009. The same approach was taken in the Labour party’s manifesto for the 2010 general election.
	The challenge that the right hon. Gentleman has to address if he is to discharge his responsibilities as shadow Health Secretary is to move on from party political ding-dongs, of which we have had too many. [ Interruption. ] The right hon. Member for Holborn and St Pancras (Frank Dobson) is commenting from a sedentary position. I have always been aware that he, at least, does not agree with the commissioner-provider split that the shadow Health Secretary operated as Secretary of State and has always said that he is in favour of considering.

Frank Dobson: Would the right hon. Gentleman care to confirm for the House that in the last year when he was Secretary of State, NHS hospitals carried out 5.7 million operations and at the end of the Labour Government’s period in office it was carrying out 9.7 million operations?

Stephen Dorrell: I am grateful to the right hon. Gentleman for drawing attention to the fact that throughout the history of the health service, under Governments of all political complexions, there has been a growth in the level of services, and improvement in the quality of services, provided to patients. It happened under the Tory Government of whom I was a member and under the Government of whom he was a member. Of course, that is delivered not by the politicians but by the doctors and nurses who work in the health service.
	The challenge faced by the current generation of policy makers, including the shadow Health Secretary, is how to meet the rising demands and the requirement for improved quality in much more constrained financial circumstances than I or he faced as Secretaries of State. He signally failed to meet that challenge today.

Nick Raynsford: This debate comes less than a week after the Secretary of State’s announcement that he is putting South London Healthcare NHS trust into administration. He will therefore not be surprised, and nor will the House, that I intend to focus on that issue.
	Not surprisingly, this announcement has caused massive alarm and concern across south-east London. Staff working for the NHS in all three affected boroughs—Greenwich, Bromley and Bexley—are all worried about whether they will continue to have a job. Patients and their relatives are worried that the NHS services on which they have depended for years may no longer be available, as rumours abound about potential cuts and closures affecting hospital services. What is most regrettable is that all this is utterly unnecessary. Indeed, there is a strong suspicion that the whole process of putting South London Healthcare into administration is driven by politics—by the Government’s wish to send a message about being tough with trusts in deficit rather than by a rational assessment of what is most likely to help the trust to improve its clinical and financial performance.
	Let us look at the facts. At the time when the Secretary of State made his announcement, briefings appeared in the media about South London Healthcare being a failing trust with poor standards of clinical care. On the contrary, the trust has shown significant improvement in clinical performance. It is one of the top five trusts in the UK in terms of low mortality, hospital infection rates are three times lower than the national average, and the four-hour target for A and E patients has been met month on month since February. For those of us who have been working with South London Healthcare to raise its performance, it is particularly galling to see the Secretary of State dismissing those achievements and incorrectly claiming, as he did on 28 June in a communication to MPs, that patients at the trust
	“experience some of the longest waits for treatment”.
	That is simply not true of South London Healthcare today. It may have been true a year ago, but, as I said, there has been improvement, and the Secretary of State has ignored that. Indeed, he himself appears to realise that his criticisms were wide of the mark, as just one week after he made that statement I received a letter from him, as did many other London MPs, starting with the following memorable words:
	“Dear Colleague,
	I wanted to write to you with a summary of the excellent performance of the NHS in your area”.
	You couldn’t make it up; talk about the left hand not knowing what the right hand is doing.
	What about the deficit? Yes, there is a deficit—about £70 million last year—but South London Healthcare has been implementing a series of service changes designed to reduce it over the next four years while at the same time improving the standards of health care. Ironically, its task has been made much more difficult by the Secretary of State, who knows only too well that two years ago, in summer 2010, he intervened to halt the implementation of a clinically led plan to reconfigure services in south-east London entitled “A picture of health”, which, after six months’ delay and a review that he imposed, was judged to meet all four of the necessary tests. His intervention merely delayed a reconfiguration process that was going to improve services and save money. Now, after a wholly unnecessary and costly delay, the plan is proceeding, with the consolidation of A and E services on two, rather than three, sites and similar moves to concentrate specialisms: stroke at Bromley; elective surgery at Queen Mary’s, Sidcup; and maternity at Queen Elizabeth, Woolwich. All those changes have helped to improve performance and have made savings. Ironically, the same Secretary of State who delayed the implementation of these improvements is now blaming the trust for the deficit without acknowledging his own part in the process.
	South London Healthcare has been in existence for just three years. It came into being as a merger of three trusts, all of which faced deficits and needed support and help to get out of their problems. As the trust’s ex-acting chair, who was removed from office today, said in his letter to the Secretary of State on 9 July,
	“We have been prepared to take strong action—we are the only Trust in London to successfully close an A and E department and move maternity services…What we have not been prepared to do is to promise more than is within our capacity to deliver; nor to mask structural issues that need to be addressed.”
	It is a tragedy that, rather than supporting the trust in its really good work in improving patient care and reducing the deficit, the Secretary of State has acted in an arbitrary and unfair way and is trying to blame the trust for a problem for which he has a large measure of responsibility.

Karen Lumley: I want to highlight some of the issues that people in Worcestershire are facing. Like many parts of the country, we are facing a joint services review of our acute trust.
	For those who do not know Worcestershire, it has three hospitals, including a private finance initiative hospital, which is costing 5% of the total health spend in the county. The PFI deal was made under the Labour Government, who have admitted that there is a case for saying that they were poor at negotiating PFI contracts from the outset. In Worcestershire, not only were they poor at negotiating the contract; they also put the hospital in the wrong place. Our PFI hospital is in the south of the county, which is all very well for people who live there, but for the 200,000-plus people who live in the north of the county, it is extremely difficult to get to. For somebody who lives in Redditch, it is far easier to get to a hospital in Birmingham than to one in Worcester.
	We are now undertaking yet another review. Once again, people in Redditch see that their hospital and their services, including A and E, maternity and children’s services, are under threat. I say once again because six years ago we were in the same position. I know that spending in our health economy has been increasing, but we in Worcestershire are paying for the overspends of the past few years and need to save money.
	I put it on the record that the people of Redditch want to retain their A and E. As their Member of Parliament, I totally agree with them. We are in the early stages of the consultation, but I urge Ministers to look closely at this matter. The Secretary of State has visited the Alexandra hospital and seen for himself what a good hospital it is. Importantly, it was paid for and is owned by the NHS. I will be asking for a cross-party meeting in due course, which I hope my right hon. Friend will agree to, because the people of Redditch are once again working together. Apart from the Labour parliamentary candidate, people have put party politics aside to work together to save our A and E.
	I know that many other Members want to speak in this debate. I just wanted to put the marker down that we in Redditch want our A and E and that I intend to fight for it.

Frank Dobson: We all know that the massive top-down reorganisation of the national health service that the Government have pushed through had not a jot of public support, that no one voted for it and that it was not mentioned in the famous coalition agreement. Nevertheless, it was proceeded with.
	We are now faced with something that was not in the election manifesto of either of the Government parties. Nor, I suspect, was it in any of the election literature of
	any of the MPs from those parties in the south-west. I do not think that any of them said, to use the phrase of the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), “We admire you people in the health service so much that we have decided that you will have to pay more for your pension and work longer, and that your pension will be smaller.” I do not think that any of the Lib Dem or Tory candidates in the south-west put in their leaflets, “We admire you people in the national health service so much that we intend to reduce your pay.” None of them said, “We admire you so much that we are going to reduce your entitlement to leave.” None of them has said, at a time when there is rightly increasing concern about the standard of care in hospitals at the weekend, “We intend to reduce or get rid of your overtime pay at weekends.” I would not wish to be admired by a Health Minister, because something nasty would clearly appear shortly afterwards.
	People in the national health service are sick to death of this massive reorganisation, of thousands of their colleagues being made redundant, of people having to reapply for their own jobs, and of being expected to do their day job while falling into line with the preposterous ideas in the major health legislation that went through this House. On top of that, they are now being told that they cannot be paid what they used to be paid. Apparently, people in the south-west say, “Pay down here tends to be lower, so let’s reduce the higher pay of people in the public sector, such as those in the hospitals, to the miserable levels that the private sector pays people here.” It is not likely that giving people even lower pay, which is always associated with poor health, will improve the public health of people in the south-west, which the hon. Member for Totnes (Dr Wollaston), who is herself a GP in the south-west, has talked about.
	What the Government have done is disgraceful and is in clear breach of their manifesto commitments. They are now attacking people in the national health service. I laud and admire people who work in the national health service. There may be some bad ’uns—there are bad ’uns everywhere—but most of them work very hard and brilliantly on our behalf, none more so than those at University College hospital in my constituency and at the Kentish Town health centre, which I was happy be at recently with Alan Bennett for the ceremony to celebrate 125 years of the Wigg practice, which serves people brilliantly. Believe me: when I talk to people at those two institutions, the main people who are denigrated are the Tory Ministers who have wished all this upon them. I join in that denigration.

Stuart Andrew: I am extremely grateful for the opportunity to speak in this debate. The NHS is clearly important to all of us. I have seen it personally because I have had a number of operations and through my working life in the hospice movement, where I saw how the care that is provided is so important to the families we were looking after. Clearly, the dedication of the staff is great and I pay tribute to them.
	Listening to the Opposition today, it is hard to take them seriously. We can see what they would do with the NHS if they were in power by their actions in Wales. They have cut the budget, resulting in an increase of 51% in the number of patients waiting to start treatment
	and an increase of 156% in the number of those waiting for more than 26 weeks. All the bad news from the Opposition is therefore difficult to swallow.
	I will give a couple of examples from my area. I recently met some GPs and clinicians to talk about the work they are doing to redesign musculoskeletal services. They have brought in innovative ways of ensuring that the patient knows exactly what will happen to them. Clinicians across primary care, community services and secondary care are working together to ensure that the patient has a clear understanding of the care that they will receive. They use map displays, which show a clear pathway, offer educational content for GPs to ensure that patients get the highest standard of care, and ensure that information is available for the patient.
	I am proud to say that on Friday, one of the surgeries in my constituency will open a new well-being centre, which will provide a place where health care, social care and the third sector can come together to provide better ways to improve health and well-being in the town.

Jim Shannon: Does the hon. Gentleman share the concerns of many Members, as I believe he does, over the closure of surgical units for children in the middle counties of England? If so, what is he doing to prevent it in his constituency?

Stuart Andrew: The hon. Gentleman pre-empts the next part of my speech and I am grateful to him for that.
	As this is a health debate, I am sure that my right hon. Friend the Secretary of State would expect me to talk about the safe and sustainable review of children’s heart units. Like other Members, I have received a number of e-mails from various organisations today. One of them said that some MPs should seek to reignite the debate and that I should think about the children because if I had children, I would move heaven and earth to ensure that the service was the very best. Frankly, throughout the campaign on children’s heart units, I have only ever thought about the children. Of course I want the very best service for them, as do the right hon. and hon. Members from all parts of the House who have worked on the campaign. I have always accepted that there is a need for change. That is why I want to discuss a few related points this evening. I know that I will have an opportunity to raise it in greater detail tomorrow, but it is important that I speak about it tonight.
	Access and travel times are incredibly important to the families who use children’s heart services. Logical health planning surely dictates that services should be based according to where the population lies. The British Congenital Cardiac Association states:
	“Where possible, the location of units providing paediatric cardiac surgery should reflect the distribution of the population to minimise disruption and strain on families.”

Andrew Percy: That is exactly the point that Members who represent Yorkshire and northern Lincolnshire are concerned about. The proposals will mean that patients will have to travel, and expecting families in northern Lincolnshire to get to Newcastle is simply not acceptable.

Stuart Andrew: I thank my hon. Friend, who brings me on to my next point. Independent analysis of patient flows showed that the majority of people in the Doncaster, Leeds, Sheffield and Wakefield area would not go to Newcastle; they would probably choose centres in Liverpool, Birmingham or even London. The NHS constitution states that patients have the right to make choices about their NHS care, yet the joint committee of primary care trusts has asserted that Newcastle could reach the minimum number of procedures if parents were “properly managed”. That flies in the face of patient choice.
	Furthermore, the review has ignored the views of the people. I do not think there has ever been a petition as large as the one from Yorkshire, with more than 600,000 people’s signatures, but it counted as only one representation in the meeting at which the decision was made. I will raise a number of issues tomorrow to do with the scoring process that was used in the review, but I believe that the change will provide a poorer quality of service for Yorkshire and Humber families. Clinical experts from the BCCA, the Bristol inquiry, the Paediatric Intensive Care Society and the Association of Cardiothoracic Anaesthetists say that paediatric services should all be under one roof. In Leeds, we have a dedicated children’s hospital with all the services under one roof, so it is ready-made.
	I urge Ministers to look into the process of the review and see whether they believe it was properly run. Given the closeness of the scores for Leeds and Newcastle, and considering the outcry that has come from Yorkshire and the Humber, I hope that they will give both centres an opportunity, until April 2014, to demonstrate that they can comply with all the standards that the clinicians on the safe and sustainable steering group have recommended. If one or both centres fail to meet any of those standards, the decision should be reviewed.
	This is a very important issue for my constituents. The number of letters that I and my colleagues from around Yorkshire and the Humber are receiving shows how strongly people feel about it, and I urge Ministers to listen to our concerns.

Virendra Sharma: Thank you for giving me the opportunity to speak in this important debate, Mr Speaker. I wish to bring to the House’s attention some of the realities on the ground.
	NHS North West London is currently conducting a flawed consultation, which is cynically being held during the Olympics and the summer months, on proposals for the reconfiguration of acute hospital services. The proposals would mean the closure of four out of nine accident and emergency departments, including Ealing’s, and the effective closure of Ealing hospital, my local hospital. My right hon. Friend the shadow Secretary of State recently described those shocking proposals, accurately, as “butchery”, not reconfiguration.
	The proposals are put forward as clinically led, but that is far from the truth. At a recent meeting convened to discuss them, consultants at Ealing hospital and GPs from right across the London borough of Ealing voted unanimously against the proposal to close Ealing hospital. Other clinicians from right across north-west London are also opposed to the changes, and the hon. Member for Ealing Central and Acton (Angie Bray), who has just left the Chamber, has rightly said that they are
	financially driven. I take this opportunity to congratulate and thank the staff at Ealing hospital, who are working hard to provide services to patients during this time of uncertainty.
	The Nicholson challenge means that across the country, £20 billion of savings must be found in the NHS by 2014, and £1 billion of those is earmarked to come from north-west London. It is clear that this is a top-down restructuring of hospital services, driven totally by financial considerations. The proposals are being railroaded through by the remnants of the old PCTs before they are abolished next April and replaced with clinical commissioning groups. That is a top-down reorganisation of local hospitals by an unaccountable body that, after making these major decisions, will no longer exist. That flies in the face of what the Prime Minister said to me at Prime Minister’s questions—that such a decision should have the support of local doctors and patients. Local GPs and patients are overwhelmingly against the proposals, so they should be withdrawn immediately. The Prime Minister has also repeatedly told me that there are no plans to close Ealing hospital. Given that after his visit to Ealing he said that he liked what he saw, I expect him to join me, local doctors, patients and all political parties in opposing the plans.
	The Secretary of State, too, is on record as saying that there were no plans to close Ealing hospital’s A and E, and as asking where all the people who use it would go. Approximately 100,000 people a year attend there, of whom 55,000 use the urgent care centre and 45,000 are treated in the full A and E department. Where will all those people go for treatment if Ealing’s A and E is closed? Other A and E departments that are not proposed for closure are already under pressure from their own population and would not be able to cope with the extra numbers. Services would suffer, and waiting times would become intolerable.
	The preferred option being consulted on also includes the closure of the Central Middlesex, Hammersmith and Charing Cross A and Es. That would be reckless and dangerous, and would leave a large swathe of west London without adequate A and E cover. Three London boroughs—Ealing, Brent and Hammersmith—would be left without any A and E. What would happen if there were a major incident similar to the Southall rail crash in Ealing or elsewhere in west London, or, God forbid, an air crash or terrorist incident?
	The plan is opposed by clinicians, patients, politicians of all parties and members of the public, and it should be scrapped immediately. I will support the motion this evening.

Andrew George: It is a pleasure to follow the hon. Member for Ealing, Southall (Mr Sharma), a fellow member of the Health Committee. He makes a strong case on behalf of his constituents, and one hopes that any reconfiguration will be evidence-based and, above all, based on clinical governance and clinical safety.
	This is an important debate—indeed, we cannot debate the future of the NHS enough, because it concerns many Members and their constituents. It draws passion and a great deal of interest, because it affects everyone’s lives. I therefore congratulate the Opposition on giving us the opportunity to debate it this evening.
	I apologise to the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns), for not having heard his speech. I had to attend an urgent meeting with a Minister to discuss the closure of a Remploy factory in my constituency. My hon. Friend the Member for Southport (John Pugh) gave me a précis of the Minister’s wise remarks as best he could—without, of course, being able to convey fully his panache and oratorical dexterity. I understand that the Minister made a number of important remarks about one issue that I want to discuss, as a Member representing west Cornwall and the Isles of Scilly, which, apart from being the centre of the world, are in the far south-west. That issue is pay and conditions for staff. As I understand it, he emphasised the point that no such independent review of pay, conditions and the salaries of staff in such an area can proceed without the full involvement and support of the unions, and their engagement in the final decisions.

Alison Seabeck: It is absolutely right that the trade unions should be involved, because this is an enormous issue, particularly for staff morale in the south-west. Does the hon. Gentleman not share my concern that thus far the consortium has shown no great desire to undertake that consultation in the south-west? That really has to change.

Andrew George: The hon. Lady makes an important point. Lezli Boswell, the chief executive of the Royal Cornwall Hospitals Trust, wrote to me on behalf of the consortium about concerns that have been raised, including by the unions, saying that once the national pay review has concluded under “Agenda for Change” it would then be appropriate, if it is at all appropriate, for any further local discussions to proceed. Without union involvement in the work of the consortium, I agree with the hon. Lady that the proposal is irrelevant and potentially disruptive and dangerous, given its impact on staff morale throughout the NHS in the south-west. My hon. Friends will be listening closely to this debate, and to the concerns that have been raised by many Members and, indeed, by staff across the south-west about the consequences for staff morale and the impact on NHS services. I certainly hope that the Secretary of State will address those issues when he concludes the debate.
	A key issue is one that dare not speak its name—it affected staff morale under the previous Government as well—but it is the increasing pressure on front-line NHS staff. The staffing levels at the coal face have never been sufficient to provide a safe staff to patient ratio. Many people have been critical of nursing and care standards in the NHS, but they often overlook staffing ratios.
	I have also expressed concerns about the out-of-hours service in Cornwall—I know that we will not have time to discuss that—and the Care Quality Commission will produce a report as a result of those concerns, which were also voiced by the hon. Member for Truro and Falmouth (Sarah Newton).
	On pay for staff in the south-west, the chief executive of the Royal Cornwall Hospitals Trust said to me in a letter:
	“In recent years NHS organisations have largely exhausted other avenues of potential cost-saving (including reducing reliance on bank or agency staff and implementing service improvement
	initiatives). Monitor…has also estimated that NHS organisations with a turnover of around £200m will need to produce savings of around £9m a year for each year until 2016/17 to remain in financial health.”
	She goes on to say that the consortium, which consists of 20 organisations in the south-west,
	“is looking at how pay costs may be reduced, whilst maintaining a transparent and fair system that is better able to reward high performance, incentivise the workforce and support the continued delivery of high quality healthcare.”
	Does the Secretary of State agree with that, and how does he intend that that should proceed? How will he protect staff and staff morale, because the consequences will, I fear, derail national negotiations on “Agenda for Change” and drive down pay and morale, particularly in an area of very low wages? I hope that he is listening.

Barry Gardiner: rose —

Alex Cunningham: rose—

Mr Speaker: The Front-Bench winding-up speeches will begin at 7.10 pm, so the two remaining colleagues can divide the time if they wish, but not if they do not. I call Mr Barry Gardiner.

Barry Gardiner: Thank you, Sir. I shall try to respect your advice.
	In November 2011, the following announcement appeared on the Central Middlesex hospital website:
	“A and E at Central Middx Hospital is temporarily closing overnight between 7 pm and 8 am starting from Monday 14 November 2011.
	The urgent care centre next to A and E will remain open 24 hrs a day 7 days a week to treat patients with minor injuries and illness.
	We are making this temporary change to ensure we continue to provide a safe service to patients during the winter months.”
	In those three paragraphs, we hear twice over that that overnight closure is temporary, which gave minimal comfort to my constituents in Brent who used the facility. The overnight closure is indeed temporary. On 2 July, a consultation entitled “Shaping a healthier future” was launched in north-west London, and residents can submit their views until 8 October this year. The consultation, promoted by a transitional body called NHS North West London, aims to centralise and rationalise hospital services in the area. Each proposal outlined in the consultation includes the closure of the A and E at Central Middlesex—not overnight provision, but the 24-hour facility—for good.
	The motion speaks of
	“the growing gap between Ministers’ statements and what is happening in the NHS”.
	I may have trouble agreeing with that, because it depends on which Minister and which statements. The Minister of State, Department for Education, the hon. Member for Brent Central (Sarah Teather), received an e-mail from me today advising her that, if called to speak, I would quote her in this evening’s debate. I wanted to do so, because she made the following three statements. First:
	“The Tories would be a disaster for the NHS, they plan a part privatised service”.
	The second quotation:
	“These cuts will hit the poorest and most vulnerable hardest”.
	The third quotation:
	“The government must take urgent steps to safeguard our local NHS”.
	Those three quotes date respectively from 2003, 2007 and 2007, when the hon. Lady was campaigning to keep open the accident and emergency centre at Central Middlesex hospital—campaigning for something which she, in her government, is now closing. No wonder her latest comment is:
	“This flawed consultation, which does not allow residents to say that they want to save the A and E, is a kick in the teeth for all local people.”
	I do not speak Parseltongue—I do not understand it—but I deplore the pretence of opposing a policy that you are pushing through in government. That is really disgraceful.

Lindsay Hoyle: Mr Cunningham, you have until 7.10 pm before the Minister responds.

Alex Cunningham: Thank you, Mr Deputy Speaker.
	Patients in my constituency of Stockton North are already feeling the pain from the Tories’ policies. The number of admitted patients who have waited longer than 18 weeks for an operation rose by a staggering 49% between May 2010 and November 2011, and I have no doubt that the figure is much higher now.
	The North Tees and Hartlepool NHS Foundation Trust faces a drastic cut to its budget of £40 million over three years. Chief executive Alan Foster has said that that is the most difficult financial position the he has ever faced and has acknowledged that the cuts will undoubtedly lead to unpopular decisions to keep the trust afloat. The trust is trying very hard, and it has even resorted to car boot sales to try to balance the books. Some of those cuts could be achieved if the Government got behind the trust and did something to ensure that the two North Tees and Hartlepool university hospitals are replaced by one midway between the two communities.
	My fear is that there will be no new hospital and the trust will be forced to close one of the existing hospitals if it is to have any chance at all of delivering £40 million cuts in the next few years. We could end up without any of the benefits of a new hospital, and the targets might still not be achievable. Such a cut would almost certainly cause irreparable damage to the trust’s ability to maintain the excellent range of high- quality services of which it is justly proud. It will undermine all the good work that has gone on in the trust over the past 10 years.
	I know that the trust will keep patient safety, quality and performance at the top of its agenda as it goes through this difficult period, but it will not be easy to deliver services to the 350,000 people who depend on them, as they have in the past. The north-east already experiences far greater levels of poor health than the national average. It must be due to the heavy industries and resultant poor environment, as our region mined coal, built ships and made chemicals and steel. The budget cuts will only worsen this position.
	The last Labour Government worked hard to reduce the kind of health inequality faced in my constituency, where men can expect to live 14.8 years less in one part of the constituency than in another. Real progress was made to close the gap, but even so, it has proved painstakingly slow, as much work requires huge resources, which are now being denied. I feel the gap growing, even though I know that Stockton borough council has recently appointed a high-calibre person to head up public health. We will not be able to make the progress everyone wants if he and the NHS are starved of resources.

Andrew Gwynne: We have had a good debate, albeit one slightly curtailed by statements. We have heard 10 speeches from Back-Bench Members and I would especially like to commend my right hon. Friends the Members for Greenwich and Woolwich (Mr Raynsford) and for Holborn and St Pancras (Frank Dobson) and my hon. Friends the Members for Easington (Grahame M. Morris), for Ealing, Southall (Mr Sharma), for Brent North (Barry Gardiner) and for Stockton North (Alex Cunningham) for their contributions. I also rightly want to pay tribute to the many thousands who work in our national health service, doing a tremendous job in often challenging and difficult circumstances.
	As we have heard in the debate today, there are growing problems in the national health service. We know that two thirds of NHS acute trusts—65%—are reported to have fallen behind on their efficiency targets. As we have heard from right hon. and hon. Members, we are starting to see temporary ward and accident and emergency closures, while a quarter of walk-in centres are closing across England. Despite the “Through the Looking Glass” world of Ministers—one where the Secretary of State for Health closes a debate—we now have growing rationing across the national health service, with treatments—including cataracts, hip and knee replacements—being restricted or stopped altogether by one primary care trust or another.

John Pugh: Does the hon. Gentleman not acknowledge that the real weakness of this debate, as specified by the Select Committee Chairman, is that the Labour party has at no point spelled out how it would meet the £20 billion Nicholson challenge? Will he tell us?

Andrew Gwynne: We set out the Nicholson challenge, but I notice that the hon. Gentleman does not defend the decisions being taken by his Government to restrict or stop these treatments.
	It is becoming increasingly clear that there is a gap between Ministers’ statements on the NHS and people’s real experience of it on the ground. In opening, the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) incorrectly said that GP referrals have gone down. Figures published by the Department of Health on 13 July 2012 show that GP referrals are up by 1.9% year on year. Those are statistics from the Minister’s own Department’s. He is out of touch. Furthermore, the Minister said that NHS Hull is not restricting procedures on ganglia, but a freedom of information request we received says:
	“NHS Hull will not routinely commission excision of ganglia”.
	That was in April 2012, and it is a fact, again showing that Ministers are out of touch. The Secretary of State claimed that there is no such evidence of treatments being restricted or decommissioned.

Daniel Poulter: Will the hon. Gentleman give way.

Andrew Gwynne: I will not, as I do not have time now.
	In the Secretary of State’s annual report to Parliament, he dismissed restrictions on bariatric surgery as “meaningless” and continued to say:
	“Time and again, he says”—
	that is my right hon. Friend the Member for Leigh (Andy Burnham)—
	‘“Oh, they are rationing.’ They are not”.—[Official Report, 4 July 2012; Vol. 547, c. 923.]
	But Opposition Members all know the truth. Aside from the evidence presented by the Labour party and the “GP Magazine”, verified by Full Fact, primary care trusts acknowledge that they are restricting access to bariatric surgery. The National Institute for Health and Clinical Excellence recommends surgery for anyone with a body mass index of 40 or a BMI of 35 and co-morbidity. Many PCTs, including NHS Stockport in my own constituency of Denton and Reddish, impose additional restrictions.
	Recent freedom of information requests of PCTs and shadow clinical commissioning groups across England have revealed that 149 separate treatments, previously provided for free by the NHS, have been either restricted or stopped altogether in the last two years, with 41 of those being entirely stopped in some parts of the country. This provides the clearest evidence yet of random rationing across the NHS and of an accelerating postcode lottery, which appears to be part of a co-ordinated drive to shrink the level of NHS free provision. From our study, it is clear that many patients are facing difficulties in accessing routine treatments that were previously readily available, and there is evidence that some patients are being forced to consider private services in areas where the NHS has entirely stopped providing the treatment.
	Of course, there has been a real reduction in the number of nurses working in the NHS. The Government have claimed that there are only 450 fewer nurses, and at Health questions last month, the Minister, the right hon. Member for Chelmsford said that the figure was “nowhere near 4,000”. But now we all know the truth: figures for the NHS work force in March 2012 showed clearly that there are 3,904 fewer nurses than in May 2010. We have seen broken promise after broken promise, including on reconfigurations.
	It was this Government who, when in opposition, spent millions of pounds during the general election putting up posters throughout the country reassuring the electorate that under the Conservatives there would be a moratorium on hospital and A and E closures. Indeed, in opposition, they pledged to overturn some very difficult reconfiguration decisions taken by the previous Labour Government. Yet, as we have seen, the moratorium has not materialised, and there is now evidence of major changes to hospital services across the country.
	It is worth remembering that the Prime Minister gave a firm pledge not to close services at Chase Farm hospital, but in September 2011, this Secretary of
	State accepted the recommendations and approved the downgrading and closure of services at Chase Farm. And there are several others, such as the Hartlepool, the King George hospital in Ilford, the East London, the Trafford General, the North London, the St Cross in Rugby and, as we have heard today, the West London, too, that have either closed or are set to close. What is becoming clear is that when it comes to reconfiguration, Ministers are hiding behind their new localism and are happy to blame the soon-to-be-abolished structures for the forthcoming closures.
	In the brief time remaining, I want to deal with Government spending on the health service. As we have learned, actual Government spending on the NHS in 2011-12 fell by £26 million.

Graham Stuart: Will the hon. Gentleman give way?

Andrew Gwynne: No, I will not.
	This was the second successive real-terms reduction in NHS spending, following a reduction of £766 million in the Government’s first year in office. This is in clear breach of the commitment given by the Conservatives and Liberal Democrats in their coalition agreement.
	Of course, a long line of professionals have come, one after the other, to express their concern about the damage that will be done to the health service if hospital is pitted against hospital, and doctor against doctor. That is where we start. The Health and Social Care Act 2012 now allows hospitals completely to change character over time. The Government have essentially set everybody on their own. Hospitals are being told, “You’re on your own. There’s no support from the centre any more; no more bail-outs.”
	We know that there are problems with the NHS meeting efficiency targets. Indeed, a survey of NHS chief executives and chairmen found that one in four believe that the current financial pressures are the
	“worst they have ever experienced”,
	with a further 46% saying they were “very serious”. More than half of foundation trusts missed their savings plan targets, according to Monitor’s review of the last financial year.
	Ministers have said that every penny saved will be a penny reinvested to the benefit of patient care, but in reality £1.4 billion of the £1.7 billion not spent by the Department of Health has been returned to the Treasury—more broken promises. It is therefore clear for all to see that there is an increasing gap between what the Government are saying and what is going on in the NHS, and the experience of ordinary patients on the ground.
	The Government have increasingly broken their promises on the NHS. They promised no top-down reorganisation and a moratorium on hospital closures and they promised to maintain spending levels in the NHS. They have broken all those promises—they are the three biggest broken promises in the history of the NHS. There is clearly a yawning gap between what the Prime Minister and others say and the reality of patients’ experience.
	During the general election, the Prime Minister said:
	“I’ll cut the deficit, not the NHS.”
	It is now clear that the Government are cutting our NHS. The NHS is important for the people of our country, and they deserve better. I commend the motion to the House.

Andrew Lansley: I was rather disappointed by the speech of the hon. Member for Denton and Reddish (Andrew Gwynne). Like the motion, the hon. Gentleman failed to say anything about NHS staff, or to reflect the admiration and respect we have for them. The motion and his speech were just another occasion for Labour to use the NHS as a political football, fuelled by nothing but distortions, inaccuracies and myths.
	I always welcome such debates, because they give hon. Members an opportunity to raise constituency issues. Many did—I will respond to the points they made—but the right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State, did not. When the Conservative Opposition raised debates on the NHS before the election, as we often did, we had an alternative policy to express and arguments to put forward. Like the motion, his speech was empty of argument and of fact, and he and the Labour party are empty of policy.
	The right hon. Gentleman told us only that he wants to abolish the Health and Social Care Act 2012. If that happened, there would be no clinical commissioning in the NHS. In fact, nobody would be responsible for commissioning. He would abolish local authorities’ responsibilities for public health in their area, which they are embracing and acting on. He would abolish health and wellbeing boards, which are integrating health and social care more effectively. He would abolish the duties in the legislation for NHS bodies to act to reduce health inequalities, which rose under a Labour Government.
	Let me address some of the points—

Grahame Morris: Will the Secretary of State give way?

Andrew Lansley: No. I will address the points made in hon. Members’ speeches, including his. He was the first Back-Bencher to speak in the debate. He talked about more support for radiotherapy. He must recognise that we committed to £150 million additional support for radiotherapy in the cancer outcomes strategy. That will be available. He mentioned CyberKnife, which is a brand name for stereotactic beam therapy. That form of therapy is available in the NHS and will continue to be available. He neglected to mention that I announced during the past few months new plans for the establishment of two major centres for proton beam therapy in this country, which will mean that patients no longer have to go abroad to access it.

Grahame Morris: Will the Secretary of State give way?

Andrew Lansley: No.
	My right hon. Friend the Member for Charnwood (Mr Dorrell) made an important point on the Nicholson challenge, which a number of Opposition Members mentioned. At least one or two of them had the good
	grace to recognise that David Nicholson’s proposals were set out in May 2009, under, and endorsed by, a Labour Government. Labour Members now want nothing to do with the consequences of meeting that financial challenge. They fail to recognise, as my right hon. Friend said, that the challenge was against the background of an expectation that a Labour Government would not increase the NHS budget, and that the challenge would have to be achieved within three years. The Conservative Government have increased the budget for the NHS. Over the course of this Parliament, it will go up by £12.5 billion, which represents a 1.8% increase in real terms. The right hon. Member for Leigh and his party were against that.
	No Opposition Member recognised in the debate the simple fact that, in the first year of this Parliament, £4.3 billion of efficiency savings were achieved, and performance improved, across the NHS. That was not even in the time frame for the Nicholson challenge. We have now had one year of the challenge. The target was £5.9 billion of efficiency savings, and we achieved, across the NHS, £5.8 billion. Things are on track, which completely refutes the shadow Secretary of State’s argument that we cannot have reform and deliver on the financial challenge at the same time. Actually, we can do both, and in addition improve performance in the NHS.
	The right hon. Member for Greenwich and Woolwich (Mr Raynsford) completely contradicted the hon. Member for Eltham (Clive Efford) on the South London Healthcare NHS trust. The latter said he was against changes at Queen Mary’s, Sidcup, but the former said that I did not get on with the changes soon enough. The hon. Member for Denton and Reddish complains from the Opposition Front Bench that I did not have a moratorium, but the right hon. Member for Greenwich and Woolwich complains because I did have one.
	Let me be clear about this: I did introduce a moratorium, and the four tests. Reconfigurations that meet the four tests should go ahead, because they will improve clinical outcomes for patients, meet the needs of the people of that area, deliver on the intentions of local commissioners, and be in line with the views of the local public. If they meet the four tests, they should go ahead; if they do not, as my hon. Friend the Member for Redditch (Karen Lumley) made clear in respect of Worcestershire, they should not go ahead. That much is clear.
	My hon. Friend the Member for Pudsey (Stuart Andrew) made good points on how clinical commissioning is bringing improvements in musculoskeletal services. He also rightly made it clear, as the right hon. Member for Leigh did not, that Wales does not meet anything like the same standards as England and is cutting its NHS budget by 8.4%. We are increasing resources for the NHS in England and improving it. It is expected that, by the end of this Parliament, expenditure per head for the NHS in Wales will be below that of England. That is what we get from a Labour Government.
	Let me reiterate to the hon. Member for Ealing, Southall (Mr Sharma) and my hon. Friend the Member for Ealing Central and Acton (Angie Bray) a point I made a moment ago. The hon. Member for Ealing, Southall should admit that the plans being looked at in north-west London are entirely the same ones considered under a Labour Government before the election. I will insist that the plans are subjected to the four tests I have described. If they meet those four tests, they can go
	ahead; if not, they will not. I advise him to continue making speeches in the House, but also to ask the general practitioners and clinical commissioners in Ealing what they think is in the best interests of their patients—his constituents. That is a good basis to start with.
	My hon. Friend the Member for St Ives (Andrew George), the right hon. Member for Holborn and St Pancras (Frank Dobson), and a number of other hon. Members, asked about the south-west pay consortium. When I went to the NHS pay review body just a couple of months or so ago, I made it very clear that the Government believe we should do everything we can to support NHS employers to have the flexibilities in the pay framework that are necessary for them to recruit, retain and motivate staff.

Frank Dobson: Meaning: pay staff less in the south-west.

Andrew Lansley: The right hon. Gentleman should not interrupt from a sedentary position. I am answering the question. Members are interested in this. When I went to the pay review body, I made it clear that, in my view, we could achieve that through negotiations on the “Agenda for Change”. That continues to be my view, and the south-west pay consortium makes it clear in its documentation that it supports such a negotiation. It is right to pursue such a negotiation nationally and for local pay flexibilities to be used in the national pay framework. That is what most NHS employers do, with the exception of Southend.
	I have made it clear, as the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns) has, that we are not proposing any reductions in pay as a consequence. I do not believe they are necessary or desirable in achieving the efficiency challenge.

Andy Burnham: I have a simple question for the Secretary of State. Is he therefore overruling the south-west consortium?

Andrew Lansley: No, because the south-west consortium has made no such proposal. Its document is clear: it wants the “Agenda for Change” national pay framework to give it the necessary flexibilities. My view is that we should do that, and I hope that the Opposition, along with the trade unions and the staff side, will support it. As a consequence, no proposal for the reduction of pay or the dismissal and re-engagement of staff is, in my view, desirable or necessary. Indeed, when I went to the pay review body, I made the point that I did not believe reduction of pay in the NHS to be necessary.
	Let me conclude. There was a lot that those of us in the Chamber did not hear from Opposition Members. Much of it was in the annual report that I published just two weeks ago—waiting times below what they were at the time of the last election; the number of people waiting beyond 18 weeks cut by 50,000; the number waiting beyond a year reduced by nearly two thirds; infection rates in hospitals at their lowest ever level; cancer waiting times met; ambulance trusts all meeting the category A8 standard; 95.8% of patients seen, treated and discharged from A and E within four hours; 92% of in-patients and 95% of out-patients saying that their care was good, very good or excellent; and patients across the NHS saying that they support the NHS and believe the care they received to have been excellent. On
	that basis, the House should reject the motion as unfair in its characterisation of the NHS and wrong in its denigration of the NHS.

Question put .
	The House divided:
	Ayes 228, Noes 303.

Question accordingly negatived.

Adult Social Care

Liz Kendall: I beg to move,
	That this House notes the growing crisis in adult social care; welcomes many of the proposals in the Care and Support White Paper including national minimum standards on eligibility, stronger legal rights for family carers, portability of care packages and improvements to end-of-life care; notes that many of these ideas were proposed by the previous administration, but believes they are now in danger of appearing meaningless without the ability to properly fund them; is concerned that the Government is considering a cap on individual costs as high as £100,000; is committed to the important Dilnot Commission principle that protection against the risks of high care costs should be provided for everyone; and calls on the Government to honour the commitment in its 2010 NHS White Paper to introduce legislation in the second session of this Parliament to establish a legal and financial framework for adult social care.
	The issue of how we provide decent care for older and disabled people and their families is one of the biggest challenges facing Britain today. Ten million people in the United Kingdom are now over 65, and that figure will rise to more than 15 million by 2030. The number of over-80s is growing even faster, and is set to double to nearly 6 million in 20 years’ time. Medical advances also mean that people with disabilities are living longer than ever before.
	The fact that we as a nation are living longer is something that we should celebrate. There have been many improvements in adult social care over the past 10 years, and I shall say more about that in a moment. However, too many people still face a daily struggle to get the care and support that they need if they are disabled or become frail and vulnerable in their old age. The ways in which we provide and fund care need major reform if we are to deliver a better, fairer and more sustainable system. That reform is vital for older and disabled people and their families who want and deserve a decent system of care and support, but it is also vital for our economy. The Office for Budget Responsibility’s fiscal sustainability report states that the primary pressure on the public finances is our ageing population. Without major changes to pensions and, crucially, to health and social care, the long-term growth of our economy and the sustainability of our public finances could be put at risk.
	Last week, the Government had the chance to show that they were prepared to meet the challenge of fundamentally reforming care and support, and many of the promises in their White Paper and draft Bill on social care are welcome. They build on Labour’s achievements when we were in government. Indeed, many of the Government’s announcements were put forward by Labour in our White Paper, “Building the National Care Service”, more than two years ago. They included a shift in the focus of local council and NHS services towards prevention and early intervention to help more older and disabled people to stay living independently in their own homes, and more joined-up NHS and council care to stop families having to struggle with the different services to get the support that they need.

Graham Stuart: I am experiencing a sense of déjà vu. Those of us who take an interest in these matters pleaded with the previous
	Government in debate after debate to take action and to make some tough decisions to ensure that we looked after our ageing population, but, time and again, they failed to take any real action. We are not building on what they did; we are having to go into the space where they failed to act.

Liz Kendall: I always respect the hon. Gentleman’s interventions, but he seems to forget that we faced up to those difficult decisions and choices on adult social care in “Building the National Care Service”. We tried to get cross-party agreement on those proposals, but they became a political football at the last general election. The hon. Gentleman should be encouraging those in his Front-Bench team to engage seriously in cross-party talks and to take the difficult decisions that need to be taken.

Margot James: Will the hon. Lady give way?

Liz Kendall: I want to make some progress, then I will give way.
	Labour proposed better information and national minimum standards to tackle the postcode lottery in care. We also proposed that everyone should have the right to have a personal budget—which we introduced—that people should be able to take their care package with them if they moved to a different area, and that carers should have the right to have their own needs assessed and met independently of the person for whom they cared.
	The difference between the Labour Government and the present Government is that we set out the difficult decisions about how those changes would be paid for. The absence of that information is the gaping hole at the heart of this Government’s plans. There is a risk that their promises of new rights and services will be meaningless without the ability to fund them properly. Indeed,
	“this White Paper is not worth the paper it's written on.”
	Those are not my words, but those of the Alzheimer’s Society, which has damned the White Paper as a massive failure. Similarly,
	“the key test for this White Paper was to deliver an urgent timetable to reform social care funding. The Government has failed this test.”
	Again, those are not my words. They are the words of the Care and Support Alliance, which consists of more than 65 organisations that represent and support older and disabled people.

Kelvin Hopkins: I entirely support the principle of a national care service, but will my hon. Friend go slightly further and be as bold as Nye Bevan in suggesting that it should be free for all at the point of need?

Liz Kendall: I know that my hon. Friend is passionately committed to this issue, and he will know that we remain determined to ensure that there is a fair, affordable and sustainable system for care and support in future.
	The Government have failed to take proper action to tackle the immediate care crisis, and they have failed to confront the difficult funding decisions that we need for the future. Last week we heard nothing but complacency
	from the Government about the desperate care crisis that faces people throughout the country. Ministers repeatedly claim that there is enough money in the system, but the truth is that the Government’s savage cuts in council budgets have pushed an already pressurised care system to breaking point.
	Adult social care accounts for about 40% of council budgets—it is up to 60% in some areas—and for the largest elements of councils’ discretionary spending. When council budgets are slashed by a third, it is inevitable that care services will be cut. Figures from the Government’s own Department for Communities and Local Government show that more than £1.3 billion has been cut from older people’s social care provision since the coalition came to power. Fewer people are receiving support that they desperately need as councils raise eligibility thresholds. Charges for vital services such as home help are soaring, with huge variations across the country. That is a stealth tax on the most vulnerable members of society. At the same time, the quality of care is being put at risk as councils are forced to pass on cuts in their budgets to care providers. [Interruption.] From a sedentary position, the hon. Member for Truro and Falmouth (Sarah Newton) asks what we did in 13 years. We increased spending on adult social care by 53%, we invested £1.2 billion in the carers’ grant, we provided new rights for carers to have their needs assessed and to request flexible working, we introduced the Supporting People programme, and we spent £227 million on extra care housing. I rest my case.
	According to the United Kingdom Homecare Association, one in 10 home care visits now lasts for only 15 minutes. That is a completely inadequate amount of time if frail, vulnerable people are to be helped to get up and to be washed, dressed and fed. Residential care is under huge pressure too. Nine out of 10 home care providers say that low council fees are creating a two-tier system, with new investment being directed only towards wealthier parts of the country. Unpaid family carers are suffering as well as they are forced to give up work, and their own health suffers because they cannot obtain the help that they need to look after their loved ones. Yet the Government repeatedly deny the scale and urgency of the care crisis.

Several hon. Members: rose —

Liz Kendall: Last week, local councils throughout the country will have listened in disbelief as Ministers repeatedly insisted that there was enough money in the system and no need for councils to cut care provision. Sir Merrick Cockell, the Conservative chairman of the Local Government Association, has said that the current system does not have enough money to provide care for
	“anyone other than the most needy, or those who can afford to pay for all of their own care.”
	Without more funds, he says, we will
	“see some of the most popular services councils provide, such as parks, leisure centres…winding down by the end of the decade.”
	The Government are astonishingly complacent about the impact that cuts in social care are having on the NHS. Last week the Secretary of State for Health brushed aside concerns about delayed discharges from hospitals, saying that they were
	“broadly the same as… last year”.—[Official Report, 11 July 2012; Vol. 548, c. 322.]

Several hon. Members: rose —

Liz Kendall: In reality, the number of days on which a hospital bed is occupied by someone who could have been discharged has risen by 18% since this time last year, and by a staggering 29% in the last 18 months. These delays now cost the NHS £18.5 million every single month, and more than a third are due to cuts in social care. The number of delayed discharges from social care has risen by 11% in the last month alone.
	Instead of burying their heads in the sand, Ministers should be taking action. Labour has called for £700 million from last year’s NHS underspend to be ring-fenced for social care immediately, and I was delighted to learn that the all-party group on local government today called for those funds to be used for that purpose, rather than being absorbed back into the Treasury coffers. I hope that, when the Minister responds, he will tell us whether he agrees.

Paul Maynard: I congratulate the hon. Lady on giving way at long last. It is nice of her to do so, and we are most grateful. Given that she began by saying that she wanted to see a consensual, non-partisan approach to the issue, can she explain why we have just heard a party political diatribe? I find that very disappointing.

Liz Kendall: I was stating the facts about the care crisis, which have been made clear not by me but by organisations representing older and disabled people, by local councils and by the NHS. It is the Government’s denial of the existence of the care crisis and their insistence that there is enough money in the system that I am seeking to correct.
	As I have said, the Government have failed to recognise, let alone tackle, the care crisis, and they have failed to face up to the difficult decisions that we need for the future. Their progress report on funding merely says that the Government support the principles of Andrew Dilnot’s commission on the funding of long-term care and support. They now claim that it is only right for Dilnot’s proposals to be considered as part of the spending review. That was not their view two years ago, when they made a clear promise in their NHS White Paper to legislate on a new legal and financial framework in the current parliamentary Session. Now we have only a draft Bill to reform social care law alone. At best that means that there will be no change in funding before the next general election, and at worst it means no change at all if the Government return to power.

Richard Fuller: Will the hon. Lady give way?

Liz Kendall: I want to make a little more progress.
	According to yesterday’s edition of The Sunday Telegraph, Andrew Dilnot has said that the delay has left older and disabled people in fear and misery. He expressed serious concern about the possibility that the Government will set the cap at a far higher level than that proposed by his commission—at £75,000 or even £100,000 rather than £35,000. He also said:
	“if you go beyond £50,000 it is less effective in giving reassurance to the population and ceases to be a way of helping people with lower levels of assets.”
	Instead of making real progress on funding reform, the Government trumpeted proposals for a national deferred payment scheme, providing loans to cover the costs of residential care.

Sarah Newton: Does the hon. Lady recall what the Secretary of State actually said when he announced his proposals last week? He made it very plain that, if the hon. Lady’s party sat down seriously with Ministers and reached the consensus that the whole country is clearly crying out for, the necessary mechanisms could be introduced in the Bill and the funding could be found in the comprehensive spending review. We need less party politics and more consensual conversations.

Liz Kendall: It was Labour Members who proposed cross-party talks, and it was Government Members who decided unilaterally to publish the progress report on which we had been trying hard to agree. The hon. Lady accuses Opposition Members of not being serious about funding reform. We are, and I will set out what we would like to happen so that those talks can proceed.
	The deferred payment schemes that were announced last week already exist in some parts of the country and are currently interest-free, but according to the Government’s plans interest will be charged, which will make loans more expensive than they are now. Many councils remain utterly unclear about how they will find the money to pay for those schemes. As the Local Government Association says,
	“Councils are not banks and the implication of this level of debt in an already overstretched system needs urgent attention.”
	The truth is that the Government have so far ducked the care challenge, and the reasons for that are clear. First, owing to their disastrous economic policy, they are now borrowing £150 billion more than they originally planned to borrow. The Treasury has pulled the plug, and has kicked long-term care funding into the long grass.

Richard Fuller: I thank the hon. Lady for giving way. As she recognises, cross-party consensus is required if we are to solve the social care problem. Care workers—the people who actually provide the care to people—do not get sufficient attention, however. One of the problems they have suffered from over many years is per-minute billing. Does she recognise that our changes to get rid of per-minute billing are worth while, and what impact does she envisage that will have on the provision of care over the long term?

Liz Kendall: The hon. Gentleman raises a serious point. I know from shadowing care home assistants in my constituency that commissioning by the minute can cause considerable problems. For instance, it does not allow the staff to meet the individual needs of those who are most desperate for help and support. As I have said, we welcome many of the proposals in the White Paper, but they need to be properly funded, and that is why I am so concerned that the issue of long-term care funding has been kicked into the long grass.
	The second reason why the Government have failed on this issue is that the Health Secretary’s obsession with reorganising the NHS has been a disastrous distraction.
	Two years have been wasted on an unwanted and unnecessary reorganisation, when everyone should have been relentlessly focused on the key challenge of our ageing population: meeting rising demand for care at a time of unprecedented financial pressure.
	The third reason is the most fundamental of all. Many Conservative Members have still not grasped the basic principle that we must collectively and universally pool the risks of facing catastrophic care costs, as we do in the NHS, in order to make things better and fairer for us all. A voluntary system that leaves it up to individuals and their families alone will not work. The only way forward is through an effective partnership between individuals and the state.

Kelvin Hopkins: I agree with what my hon. Friend is saying. The Government keep on talking about consensus, but the problem is that we say yes to Dilnot, but they do not. If they were to say yes to Dilnot, we might have a basis for consensus.

Liz Kendall: We remain serious about trying to achieve cross-party consensus. If one party comes forward on its own and proposes a controversial and difficult decision, that always leads to a political fight; we saw that only too clearly before the last general election. However, we need cross-party consensus because this is a long-term challenge. We have to try to get agreement so that, whichever party is in power, people know there is a system that they can understand and pay for in future.
	Members on the Government Benches have criticised Labour’s record in government, but we are proud of our achievements on social care. We increased spending by 53% when we were in government. We helped drive up quality through national performance assessment of local councils and independent inspection of care services. We championed integration, with new legal powers for the NHS and local councils to pool budgets, and new care trusts to jointly commission care. Those care trusts will be swept away under the Health and Social Care Act 2012. We supported carers through the carers grant and new rights for carers. We introduced the first ever national dementia strategy, and we backed improvements in housing through the Supporting People programme and extra care housing. [Interruption.] The hon. Member for Reading East (Mr Wilson) mutters from a sedentary position that that is not real action. He should try telling that to the carers we supported through breaks that are now under threat, and the people who have benefited from extra care housing and the Supporting People programme, which his Government have cut by 12%.
	We understood that we had much further to go, however. That is why before the last general election we published plans for fundamental reform, including difficult decisions on how care should be funded. We tried to get cross-party agreement. We did not succeed, but we are determined to try again now.
	A year ago, my right hon. Friend the Leader of the Opposition made an open and sincere offer of cross-party talks, and it is a matter of genuine regret that the Government unilaterally decided to publish their own progress report on funding, rather than the joint report we had wanted to agree. Labour remains committed to serious and meaningful cross-party talks.
	I hope that the Minister will tell the House whether the Government will commit to addressing the current funding gap as well as future reform. Andrew Dilnot says that that is vital. Will they also set a clear timetable for reform, with legislation on funding reform in this Parliament, as Labour has called for? Will they agree to include their Treasury team in the talks, which Labour has offered from the start?

Daniel Poulter: One of the authors of the Dilnot report was Lord Warner, who was a member of the previous Labour Government. He made the point that one of the reasons for the funding crisis is that the previous Government failed to invest adequately in social care; it received only 70% of the funding compared with the NHS. That was one of the major failings of the previous Government. They should have invested more in social care when the sun was shining and the country had the finances to do that.

Liz Kendall: I politely say to the hon. Gentleman that we did not cut local council budgets by a third. I have always said that social care budgets have been under increasing pressure for many years, which is why we desperately need funding reform. I know that he supports that reform and will work with us in the years ahead.
	The Government’s decision to kick the issue of long-term care funding into the long grass is a bitter blow for older and disabled people and their families. It is a huge disappointment for local councils, which are desperate for a new social care settlement, and it is a disaster for our NHS, which will face intolerable pressure as our care system crumbles further still. This issue will not go away, because our population is ageing. Our care system needs fundamental reform—reform this Government have so far failed to deliver. I commend the motion to the House.

Paul Burstow: Let me begin by striking a note of agreement between Government and Opposition, before moving on to the areas where we disagree. I agree with the hon. Member for Leicester West (Liz Kendall) that our debates about our ageing society are too often couched in terms of burdens and impacts on public expenditure, when they should be a cause for celebration as we have more people living longer and living healthier for longer. That stands as a tribute to our national health service, our local authorities and many others besides.
	I sat in the House for 13 years in opposition to a Labour Government, and it became very clear to me that, despite the wealth of the nation being much greater at that time than it is now, the Labour party was not willing to tackle the pressing need for serious systemic reform of social care. I shall talk in a moment about the Labour Government’s last-minute moves to address that agenda.
	Social care is Bevan’s orphan. It was left over after the NHS was established in the 1940s, and it has suffered ever since. It has been hidden behind its favoured sibling, the national health service, out of sight until life takes a turn and tips people into crisis. Social care’s founding principles date back to the Poor Law; it was a poor relation to the NHS, ripe for reform, but neglected for decades.
	Much of last week’s reporting about the Secretary of State’s statement in the House and the publication of the White Paper and draft Bill gave the impression that the only subject that was talked about was who pays for care—where the line is drawn between what an individual personally is responsible for in meeting their care costs and what costs the state would pick up. The Government do not dispute that that is an important issue, and we have made significant progress on that agenda, but it is not enough simply to redraw the boundary between personal responsibility and state support, because the system of social care in England is undoubtedly broken.
	Given that there were 13 years of Labour inaction, the hon. Member for Leicester West must face up to some of the challenges in respect of social care. A White Paper finally emerged in the dying days of the last Labour Government; it was published on 30 March, just seven days before a general election was called. That is not good enough; it is too little too late. What did that White Paper say? It talked about national eligibility, but when? It was by 2015, so it was going to take Labour five years to introduce that change. On portability, it did not commit to ensuring that support would be provided immediately in the area to which the person was moving. In other words, there was still a risk of interruptions. In addition, that Labour White Paper said nothing about the rights of carers. The hon. Member for Leicester West was absolutely wrong when she told the House that Labour was responsible for introducing carers legislation. Back-Bench Members in this House, tirelessly arguing the case, were responsible—[Interruption.] Labour, Conservative and Liberal Democrat Members supported those many measures over a number of years, but none came from the Front-Bench and none came from the Labour Government.

Hugh Bayley: I would like to get back to the issue in hand and call a spade a spade. The only substantial asset that most families have to pass on to their children and grandchildren is the home they live in. If the Government want a new inheritance tax, would it not be fairer to levy it at the same percentage rate on rich and poor alike, and not simply target those people who have the misfortune to fall ill at the end of their life?

Paul Burstow: I will come in a moment to our response to the Dilnot commission recommendations, so I will deal with the hon. Gentleman’s point at the right time.

Hugh Bayley: Now would not be bad.

Paul Burstow: No, I am talking about the time at which in the sequence of my speech I will make the point about the Dilnot commission recommendations.
	I wish to make one other observation on the national care service White Paper that the Labour Government published seven days before the last general election was called. Our White Paper addresses the end-of-life care issues, but Labour’s failed to address them.

David Anderson: The Minister is rightly critical of the failure of the previous Government to bring in care for the people of England. Does he support what was done in Scotland by the previous Government?

Paul Burstow: I am not certain which thing the hon. Gentleman is inviting me to support. Many measures were introduced by the coalition Government in Scotland over a number of years to reform the social services system in Scotland, not least some relating to adult safeguarding which this Government are now making progress on.

Andy Burnham: I think that the Minister has unfairly misrepresented the process we went through in the last Parliament. We did not just have a White Paper before the general election. We had a Green Paper in the summer of 2009, and the whole process was kicked off in the 2007 spending review. Upon a request from the then shadow Health Secretary, I agreed to cross-party talks. So the Minister is unfair in saying that nothing was done and then a rabbit was produced from the hat. May I say to him that the White Paper that I produced before the election addressed both service reform and funding? I am afraid that the same could not be said of the White Paper that emerged last week.

Paul Burstow: That is interesting, because the White Paper that was published seven days before the general election was called carried no details on who should pay, what they should pay or when they should pay. It contained no details of that sort, and I urge people to read it and compare it with the White Paper, draft Bill and other details that we published just last week. In 13 years, when the money was available, the Labour Government did not do anything; they left it until the last seven days and even then did not come up with the details.
	In the space of two years, this coalition Government have advanced further and faster than any in the previous 20 years on addressing a wide range of issues and challenges and backing that with tangible action. Unlike what happened with Labour’s royal commission, so firmly kicked into the long grass, this Government have accepted all the recommendations of the Dilnot commission as the basis for a reformed system. Many of those recommendations are translated into the legislation that we published last week. Crucially, the Government accept the principles of a capped cost system as the basis for protecting people from catastrophic costs. Labour’s motion seems to suggest that Labour does, too. I want to make it clear that we are keen, still, to engage with the official Opposition and other stakeholders in reaching a final settlement on this question of the boundary between the state’s responsibility and the individual family’s responsibilities for meeting care costs.

Mark Field: Does the Minister not recognise that any cap, be it at £35,000 or £60,000, as was initially proposed by Dilnot, is likely within a very short time to be wholly inadequate, given the funding constraints that we are under? The harsh reality is that people who wish to preserve an inheritance for their children—that is an understandable desire—must recognise, as must their children, that those children will have to take on the burden of looking after aged parents, in both time and financial terms. It sounds like a hard truth, but it needs to be put on the record, because otherwise we are not going to get any further forward in dealing with this matter.

Paul Burstow: The hon. Gentleman expresses an opinion that is held by many people, but the Government’s position is not to take that view. We take the view that a cap on care costs is an important component in a redesigned system for funding in this country. What we have said clearly is that we have to address how that is paid for as part of a spending review. That is why we believe that both a cap and an increase in the means-test threshold provides the necessary assurance for a family to plan and prepare for care, and provides the mechanisms by which the financial services industry can grow and develop to offer appropriate products.

Mark Field: Is there not a problem with what the Minister has said? I understand that this is an incredibly difficult issue, which we all have to deal with. I have lost both my parents. One died at the age of 70, only 18 months ago, at a time when we were on the cusp of putting her into full-time care, which would have been ruinously expensive. Is not the problem with all this that if we put in place today any system with a fixed cap, it will almost certainly be superseded by events and will then be seen as unjust for future generations?

Paul Burstow: The hon. Gentleman identifies one of the issues associated with the design of the introduction of a cap. It is worth pointing out that the interaction between the cap and the means-test threshold means that every family would have a different level for which they would be liable to meet their care costs. The issues relating to design are real, as are those about how to meter the system from the point someone enters it, and they require detailed work as part of the design of an effective implementation alongside the costings of it.

Hugh Bayley: The hon. Member for Cities of London and Westminster (Mark Field) is right to identify that there is a link between inheritance and the high cost of end-of-life care for people. May I put it to the Minister that if there is a cap of £100,000, the entire inheritance could be wiped out for a family who have a modest home in the north of England, whereas somebody living in a home worth 10 times as much in southern England would still maintain a large proportion to pass on?

Paul Burstow: That is why we have to explain this clearly. By lifting the means-test threshold to £100,000, the interaction between the absolute cap and the means test means that the amount the individual will ultimately pay as their lifetime contribution towards their care costs is related to their wealth. I urge the hon. Gentleman again to look at both the tables and the graphs in the progress report, as he will see exactly how it protects the assets of a family, even in the scenario he has described.
	It is also important to understand that redrawing the boundary between what the individual pays and what the state pays does not—things all too often were conflated in this way last week—add any new spending power to the system. That leads me to the question of getting funding into the system. Before the 2010 spending review, the Dilnot commission urged the Government to protect baseline funding for social care, and we did just that. In October 2010, we confirmed an extra £7.2 billion of support for adult social care, which, together with a programme of efficiency, was sufficient to protect access to support. That included an unprecedented £4.2 billion
	of NHS resources to support social care, to promote integration and innovation, and to support the expansion of reablement services. The Labour party wants to paint a picture of doom and gloom up and down England on these services, tarring every council with the same brush of being crude cutters of services, when that is not the case.

Kate Green: Perhaps I could describe to the Minister what is happening in Trafford, which has a Conservative council and is where my constituency is located. We are seeing a twin squeeze, despite the Minister’s apparent sanguinity about the funding. On the one hand, we are seeing thresholds for access to care being raised as a means of rationing the way in which the money is spent. On the other hand, as care providers are telling me, commissioners are reducing and reducing the price they are prepared to pay providers to the point where they can hardly sustain their business at all or meet minimum wage legislation.

Paul Burstow: We know from the surveys that although last year there was a cash freeze in the increases that local authorities paid to provider organisations, this year across the country the average was a 1.4% increase. Again, that does not quite tally with the picture that some hon. Members want to paint.
	It is also worth saying that the picture of local authorities grappling with tough budget settlements is complex. Different councils are responding to the pressures on budgets in different ways. Some are acting in a very smart way, as the Demos report, “Coping with the Cuts”, revealed. Such councils are protecting access by focusing on reablement services, helping more people to get back on their feet without the need for long-term support, which is better for the individual and more cost-effective. Indeed, the latest figures from the Association of Directors of Adult Social Services reveal that councils are protecting front-line care.

Roberta Blackman-Woods: Would the Minister agree to look closely at the report of the all-party local government group on social care, published today? It makes very clear that a funding gap still exists and recommends that NHS money should be used to plug that gap. Will the Minister commit to continuing to do that and to considering the other recommendations in the report?

Paul Burstow: Obviously, I will happily look at the report and I look forward to meeting the all-party group to discuss its findings and recommendations later.
	I want to report to the House the findings of the ADASS survey, which was published recently. Last year’s survey found that for every pound saved by local authorities in social care, 69p came through greater efficiency. This year, it found that that had risen to 77p in every pound. Yes, some councils are cutting services, and last year 23p in every pound that councils saved came from service reductions, but this year that figure is just 13p in every pound. Local authorities are getting smarter in organising their services, so I want to pay tribute to those councils and councillors who have worked hard with service users, carers and providers to protect services to make the best possible use of the extra money the
	Government have provided. As a result, between last year and this year, council budget spend on social services has gone down by just 1%.

Sheila Gilmore: On the question of efficiencies, would the Minister include councils that tendered a service and made a saving, but to the detriment of the end user of the service? That is how we got to the 15-minute, short-term care options. Is that an efficiency or a cut in service?

Paul Burstow: When there is a crude race to the bottom and contracting is by the minute simply to ration access to the service, resulting in a care home provider or home care provider delivering care on a very time-and-task oriented basis, that is totally unacceptable. We know that in places such as Wiltshire, where home care services are organised on an outcomes basis, that is delivering better results for the service users and releasing resources to reinvest in services.

Richard Fuller: When I intervened earlier, Mr Deputy Speaker, I forgot to refer hon. Members to my entry in the Register of Members’ Financial Interests as the director of two care companies.
	The Minister is absolutely right to say that there is a patchwork of responses from local authorities. I absolutely welcome the end of per minute billing, which is a tremendous step forward, but I draw the Minister’s attention to the comments made by the hon. Member for Stretford and Urmston (Kate Green). She talked about the pressures of meeting the minimum wage and the pressures that local councils are putting providers through. The Government must consider that issue, because there is exploitation in some areas. As businesses and charities try to meet the requirements local councils are putting on them, workers are finding it difficult to achieve a sustainable wage in providing care services.

Paul Burstow: My hon. Friend is absolutely right to highlight that issue, which the Low Pay Commission has commented on over a number of years, including before this Government came into office. In our White Paper, we make it very clear that local authorities, as the commissioners of such services, must be mindful of their responsibilities in ensuring that the resources they provide to providers are sufficient to allow them to fulfil their legal obligations.

Heidi Alexander: The Minister talks about the financial pressures faced by local authorities in providing care to elderly and disabled residents, but is he aware that the cost to local authorities of self-funders who have to fall back on the state is in the region of £1 billion a year? Does he agree that that is a very unpredictable thing for local authorities to deal with? What proposals does he have to help local authorities in that regard?

Paul Burstow: I am grateful to the hon. Lady for her question, because it allows me to talk about some of the points I think will directly address it. Reform of our care and support system is about more than just who pays for care; it is also about some other very important issues. A central proposition in the White Paper we published last week concerns the move from a service focused on managing crisis, and often not doing so very
	well, to one focused on supporting people’s well-being by concentrating on early intervention and prevention. That is why, alongside the White Paper, we published a draft Bill that will underpin the reforms we intend to make, consolidating, simplifying and modernising the legislation. The Bill sets out for the first time in statute some very clear governing principles about how decisions are made in social care, focusing on people’s well-being and living by the idea set out by our first White Paper in government of “No decision about me, without me”.
	The Bill sets out a number of important changes that go to the heart of people being able to plan, prepare and have proper choice about the care available to them. First, it makes it a requirement for local authorities to ensure that there is a universal offer of information and advice so that people can plan and prepare. Secondly, it requires for the first time local authorities to focus on prevention. Thirdly, it requires a sufficiency of quality care so that choice is available to people locally. Fourthly, it requires integration and co-operation not just between the NHS and social care but between those agencies and housing.
	The Bill will not only do that; it will simplify the point of entry into the state system. It will ensure consistent national eligibility and, for the first time in Government legislation, will ensure that there are rights for carers not just to an assessment of their needs but to support for those needs. It will also deal with the often mentioned issue of protection from disruption when people move from one part of the country to another or when a child moves from children’s services to adult services. It will guarantee continuity of services, which is not currently provided for.
	Personal budgets, which were started by the Opposition but have not stuck well because of the legal framework, will for the first time be given a clear legal basis. I am delighted to say that whereas when this Government came to office in 2010 we inherited 168,000 people receiving personal budgets, by March of this year 432,000 people were benefiting from them. There will also be clear legal duties on the NHS, police and councils to safeguard people.
	At the heart of our White Paper reforms is the notion that we need less variability on quality, to ensure that providers are responsible for driving up quality and accountable for doing just that, and to have more and open information about the quality of provision. That is why our provider quality profiles will provide that information in a way that will allow people to compare and rate providers for the first time and why we are putting an extra £32.5 million in to support those services.

Andy Burnham: The Minister is mentioning the things in the White Paper that he will ask councils to do. Can he give us a figure tonight for how much the Government have estimated that the cost to councils will be of providing all those things and tell us how councils will pay for it?

Paul Burstow: I will come on to give a specific figure in a moment, so the right hon. Gentleman will have to be patient.
	I wanted to pick up again on the point about the White Paper ruling out crude contracting by the minute—a culture of clock-watching which has been allowed to grow up for years in too many places and which is not good for dignity, respect or quality. Under the Labour Government there were years and years of delay and dither when it came to addressing the quality of care workers and health care assistants. This Government are putting in place a code of conduct and national minimum training standards, and will double the number of people able to access apprenticeships in the care sector to 100,000.

Andrew George: I am grateful to my hon. Friend for his remarks. I hope I am not taking him back too far, but given that he is talking about the integration of services, particularly among authorities, and implying the portability of assessments for those with care packages, will he comment on the extent to which the Local Government Association has approved and supported the proposals in the Government’s White Paper?

Paul Burstow: On the proposals for portability of assessment and guaranteed continuity of care, the LGA is certainly aware and has been engaged in the consultations that we undertook last year as part of our preparations for the White Paper. It did not, of course, negotiate line by line the text of the White Paper, but it has the opportunity, as does everyone else, to participate now in the scrutiny of the draft Bill that we introduced. I hope the LGA will do so. We wish to engage with the LGA on these issues.
	Integration is an important part of these reforms. Too often, people feel bounced around the system. What we do for the first time in the White Paper is set out a number of important steps towards more integration of the two existing systems.

Jim Shannon: The Minister has used the term “integration” several times. In Northern Ireland we have an integrated health and social care system, which is working extremely well. I am conscious that that is very different from the position on the mainland. Are there lessons from the integrated system in Northern Ireland that could be applied here? We have done it well in Northern Ireland. Perhaps the example could be used here.

Paul Burstow: From my own limited study of the system and from visits that I have made over the years, one of the conclusions that I would draw, which is at the heart of our reforms as well, relates to culture and collaborative behaviour across the various parts of the system. That has been essential to delivering genuinely integrated care in some parts of Northern Ireland. I believe it is essential to delivering genuinely integrated care in England as well.
	I mentioned earlier that end-of-life care was an omission from the Labour Government’s last White Paper. It has not been omitted from ours. We are doubling the budget of the pilots that we have instituted to test the patient funding mechanisms and to make sure that we have the necessary data to understand the benefits of a free social care system at end of life. We want to make it
	clear that we see the merits of such a change, and it is why we want to make sure that we have the information on which we can base the final decision.
	Our goal is to shift the focus of the system to prevention and early intervention, not to wait for the system to stutter into life when a crisis strikes. We want to make it easier for people to plan and prepare, both to avoid and reduce the need for care and to meet the need for care in the first place. Last week we laid out a reform agenda of universal information and advice, national eligibility, deferred payments, integration of health, housing and social care, better transition for children to adult services, and support for carers. Together those constitute the most comprehensive overhaul of adult social care in 60 years, and they are a contrast to the motion before us, which adds nothing, says nothing about how change will be paid for, and says all that it can to scare people about the current system.
	Rather like 13 years of a Labour Government, today’s motion gets us nowhere. That is why we are investing an extra £300 million in the system to support change, and why I urge my right hon. and hon. Friends to vote against the motion.

Several hon. Members: rose —

Nigel Evans: Order. To accommodate as many Members as we can, a five-minute limit will be introduced, with the usual overtime for two interventions.

Michael Meacher: The Minister, as always, sought to present a positive picture of his proposals, but I continue to be struck by the internal conflicts of the White Paper.
	The whole thrust of this Government has been to shrink the state, but Dilnot will clearly expand it. The Chancellor, who torpedoed Labour’s social care proposals just before the last election by claiming that they represented a death tax, is now supporting his own death tax, only this time it will be £35,000 to £50,000, as opposed to Labour’s £20,000. Now the Chancellor has once again sabotaged a fair and reasonable inter-party settlement, which is plainly needed, by abruptly breaking off the talks and introducing a pretty vacuous White Paper with no costs in it—or, to use the words of Sir Alec Douglas-Home in 1964, a menu without the prices.
	Furthermore, the Chancellor clearly wants the adult social scheme to be voluntary—I think this is what lies behind many of the difficulties—but the sums add up only if there is compulsory risk pooling. Yet the Chancellor—it is he, rather than the Secretary of State, whom we must deal with—still will not face up to the ineluctable logic of a mandatory adult social care system, and he is still trying to dodge it in two rather unscrupulous ways: first, he is kicking it into the long grass by postponing it to the uncertainties of the next spending review in 2014, even though gross neglect is endemic and reform is needed urgently; and secondly, he is evading today’s realities by ignoring any need for upgrading standards. The Minister referred to upgrading standards, and clearly he wants to, but the means with which to do so are incompatible with the White Paper. The Treasury’s £1.7 billion is purely a dead-weight cost to protect
	family inheritances. It takes no account of rising care costs or the imperative need to lift care standards, which in many cases shame a civilised society.
	This is where we come to the crux of the matter. At present, many local authorities pay only for 15-minute or 30-minute visits, and many do not pay for the journey time, even though that is part of the contract, or the petrol costs, which care providers are obliged to provide themselves. Frankly, it is impossible in 15 or 30 minutes to get an elderly and often infirm person out of bed, to clean the sheets, which may well be soiled, to get him or her dressed, washed and fed, to clean and tidy up and, of course, to engage in some kind of conversation to generate some decent human relationship. Equally, it is impossible, as my hon. Friend the Member for Leicester West (Liz Kendall) pointed out, with the minimum wage rates paid by local authorities because of their squeezed budgets—a funding shortfall of at least £1 billion this year—for care providers to offer the higher standards the Minister talked about and which they want to provide and which the service users deserve.
	How is the big black hole in the White Paper to be dealt with? The Local Government Association says that the gap between the money available this year and the predicted cost is about £1.4 billion, stretching to £16.5 billion by 2020, when spending on social care will exceed 45% of council budgets. Against that shortfall, the £300 million of extra funding announced by the Secretary of State in his statement last Wednesday looks derisory.
	This dilemma is by no means insoluble. The long-term costs of Dilnot are estimated at about £3 billion a year. In his Budget four months ago, the Chancellor had a choice in the allocation of precisely such a sum, but he decided to spend it on the top 1% earning more than £3,000 a week by cutting the 50p rate of tax. For the same amount of money he could have funded Dilnot in full, but for this Chancellor the priority are the super-rich, not the elderly, infirm or disabled people in need of social care. The long-term answer to this problem is the introduction of a new social insurance scheme.

Fiona Bruce: I welcome the Government’s White Paper “Caring for our future: reforming care and support” and its priority of putting the well-being of the cared for and their carers at the heart of its approach. As the Member who represents the constituency with the highest proportion of elderly people in the north-west of England—there are 72,000 carers in Cheshire—I particularly welcome the proposals.
	For the first time there will be a clear legal basis for the cared for and their carers having their own individual care and support plans, a tangible recognition of the utterly invaluable contribution that some 6 million carers make, many of whom often work more than 50 hours a week, at great personal cost. With 2 million people moving in and out of caring roles each year, the Government are right to recognise that giving carers a right to personal assessments and plans is a priority so that their own health and well-being are supported and recognition is given to the fact that they, too, have lives to live.
	I am also pleased that the Government have already allocated £400 million for carers’ breaks over the current five-year period, but it is important that that is reviewed
	to ensure that the effectiveness of such payments is maximised. I welcome the new duties placed on local authorities, which will substantially help the cared for and their carers to access appropriate support, as the fragmented health, housing and care support services that have existed until now have caused at best frustration, and at worst despair.
	Clearer dissemination, and the duty on local councils to provide advice and preventive services, should go a long way towards alleviating the problem described by one volunteer in the care sector, when she said that social workers just do not have time to help signpost carers to information, advice and support.
	The Government are to be commended for their commitment to work towards the assurance of quality care standards through improved training provision for care workers, the introduction of a new code of conduct and of minimum standards for care workers and the appointment of a chief social worker, and for their aim of doubling the number of care apprenticeships to 100,000 by 2017. In that respect, I commend the excellent work of the apprentices on Cheshire East council’s A-Team, who are already blazing a trail through their apprenticeships as carers for the elderly in our community —soundly rebutting the myth that younger people do not care for our elderly or give them the dignity and respect they deserve.
	I also welcome the Government’s proposals to fund adaptations to keep the homes of the elderly safe, because the NHS is estimated to spend £600 million a year treating injuries caused by hazards in inappropriate housing—the majority of cases associated with falls. The Government’s new care and support housing fund of £200 million over five years, to support the development of specialised housing and adaptations of homes, is particularly welcome.
	I welcome also the Government’s commitment to abolish per-minute billing for care visits. That will be music to the ears of a distressed care worker who came to my surgery and said that she was seriously considering leaving the profession, because not only was she unable to provide within the time frame allocated the care needed for those she visited, but there was nothing like the necessary allocation of travel time between the homes that she needed to visit. In some cases, they were even in different towns. She showed me her timetable, and I can only say that I entirely agreed with her.
	I welcome in particular in the White Paper the Government’s recognition that if we are to address this massive challenge and make a reality of good quality, comprehensive care provision for all, which I am sure is everyone’s aspiration across the House, we will do so only if we harness the energy, resource and skills of the whole community, including community groups, many of which are highly professional and which work very hard to support carers and the cared-for.
	I am very pleased that the Government have committed to working closely with Age Action Alliance jointly to find practical approaches to improving the lives of older people; that they have decided to invest funds through Big Society Capital, so that social enterprises, charities and voluntary groups can access greater resources in order to make a difference in communities; and that they have decided to involve those communities in strategic decisions on health and care services through
	local health and wellbeing boards. That will be particularly welcomed by Crossroads Care Cheshire East, whose director told me, shortly after I was elected in 2010, that
	“we could do so much more and add so much value if we were more involved in strategic discussions about care provision.”
	The Government’s proposals in the White Paper are to be welcomed.

David Anderson: In 1989 I became a care worker after losing my job as a coal miner. I did so almost by mistake, but it was one of the best decisions I ever made, and over the next 16 years, as a care worker and as a representative of people working in care, I came to realise that we can look at care in three ways: we can provide none, provide it on the cheap or provide quality. We cannot do a combination of the three, and I hope that in the Chamber tonight we all agree that, if we are going to do quality care, we need to look after the work force properly, train them properly, treat them like professionals, have them in numbers, respect them, treat them with dignity, have the resources in place and give them some responsibility. They respond to that if allowed to, and the best way they respond is by showing respect for, and treating with dignity, the people they are taking care of, building the trust and confidence not just of those they are caring for but of their carers—their family and their friends who look after them.
	I believe that my Government did some good things over their 13 years in office, regardless of what the Minister says, but in truth we did not do enough. In 1999 we set up the Sutherland commission, but we backed down on it—we chickened out. We did the right thing in Scotland, and, yes, it was done under coalition government, but the commission was set up by a Labour Government.
	We should have done more, and we have a chance today to do more. My view is clear: why is someone needing care because they cannot take care of themselves different from someone who needs care because they are ill? We never say to anyone who needs physical or mental care on the NHS that they cannot have it, but we do say that to people who cannot take themselves to the toilet, bath themselves or take their medication. We would never do that with children, so why should we do it with the elderly and disabled?
	I am clear that there is a cost; of course there is. I want to ask the Minister about some of the things he was saying earlier, and I hope that I get a response. What resources are we going to put in? If there are to be 100,000 apprentices, what will that cost? If there is to be a new code of conduct, what is the implication of that? If there is to be extra training, what will that cost? All those things are welcome, but if we are just going to talk about them and not resource them, we might as well not bother to talk about them.
	I would like to have clear in my mind the issue raised by my right hon. Friend the Member for Oldham West and Royton (Mr Meacher). What is the difference between what is now proposed and the death tax that the current Secretary of State so cleverly used during the last election to undermine the stuff that my Government were trying to do? He talked then about £8,000 a year and a saving of £40,000 for everyone. That has all disappeared—it is all under the carpet. Did he mean what he was saying back then and does he mean what he is saying now?
	Yes, if we are going to do this properly, there will be a cost—but we always find the cost of going to war and of extending the nuclear deterrent. In the past week, we have found the cost of taking 3,500 troops off duty to save the embarrassment of the Home Secretary. If we can do all that for those reasons, why can we not do it to take care of the elderly, vulnerable and frail in this country?
	We were attacked by the Minister, who said that Labour MPs were moaning and whining on. That is part of the game that we play in this place, but what about what other people are saying? The Care and Support Alliance says that
	“the social care system faces collapse”,
	while the Alzheimer’s Society says:
	“Millions of vulnerable people had been promised vital reform but today they are being massively let down.”
	Mencap says:
	“this promising blue print will never get off the ground if it fails to address the chronic underfunding in social care.”
	Finally, the UK Home Care Association says:
	“The Coalition Government’s White Paper has failed the frail and disabled”.
	Those are those organisations’ words—not mine, and not my party’s.
	Like other Opposition Members, I believe that the only real answer is a care system funded from general taxation. We have a generational chance to make this a crusade, just as 60 years ago people in this House made a crusade for the NHS. I know that some Government Members will say that that has been anathema, because ultimately the NHS—when we get down to the bare bones—is socialism in action. It is socialism delivering for the people of this country. What I want would be exactly that—the strong providing for the weak, not the weak being let down by the strong. We have the chance to do that. It is a challenge for this generation. The question for all of us on both sides of the House is: are we up for it?

John Pugh: I want to be constructive. I fear that this debate may take a different route from that taken in the recent consensual Back-Bench debate. We all recognise that the cost of adult social care is a problem not just for this country, but for every advanced society that we can think of. The outline is fairly familiar: funders, private and public, feel stretched and frightened by demographic change and the elderly are scared and anxious about mounting costs. Treasuries throughout the world are nervous whenever the issue crops up, and normally they vacillate. Last week, the Government were, in part, accused of that—of dragging their feet.
	That is nothing new. Back in 2009, following the publication of the Green Paper, there was very much the same thing. The current Secretary of State, who was then the shadow Secretary of State, said:
	“One debate always seems to roll into another with this Government. We need a decision, and we need serious, costed proposals to be the basis for that decision.”
	The current shadow Secretary of State, then the Secretary of State, said:
	“we are putting forward three broad options for the country to debate, and it would be wrong to force the pace of that debate.”
	For the Liberal Democrats, my hon. Friend the Member for North Norfolk (Norman Lamb) said that the Green Paper
	“comes 12 years too late. It is this Government’s shameful legacy that they will leave office having failed to reform a system that the Secretary of State”—
	now the shadow Secretary of State—
	“himself has described as a cruel lottery.”—[Official Report, 14 July 2009; Vol. 496, c. 160-62.]
	When social care is viewed as a sustainable enterprise, Governments always see it as involving a big—and, worse still, an uncertain—sum, and that is why Treasuries usually baulk at it and we make very little progress. Governments are far happier in clarifying people’s rights and then passing the buck to local authorities. What paralyses Governments is the potential, not the identifiable, cost—what it is and how we are going to share it out —and that amounts to a huge political headache.
	In order to resolve this, we need to do two things. First, obviously, we need to get a handle on the costs; but secondly, we need to work out a way of trying to defray them. Elderly people to whom I have spoken following our recent debates and last week’s statement have spoken in slightly different terms from how we speak here. They are sceptical about some of the Armageddon scenarios. They are resentful about their perceived lack of contribution to society—not in the past but currently. They do not see themselves, en bloc, as a drag on society.
	We know that some people incur massive costs because they are frail, disabled, suffer with dementia and so on, and the social, personal and family costs are appreciable, but we also know of many pensioners who make a huge family and social commitment, and some who are even in employment. My predecessor, Lord Fearn, still has a delivery round of 500 copies of “Focus”, as does his wife, and they are both in their 80s. That shows the benefits of delivering “Focus”. We do not know enough, and need to know more, about how we get people into the category of the fit and keep them out of the category of the frail. We need to know why people end up in one category or the other and what the relative costs are of maintaining them there in terms of drugs, treatment and so on. We do not know whether by advocating an active, healthy old age we are deferring costs or eradicating them. The science of gerontology has an appreciable way to go. It is not clear to me, and probably not to many Members, how public health can move people into the better category of the fit and away from the category of the long-term frail.
	My main point—to some extent it is not mine, as it was suggested to me by what the hon. Member for South Thanet (Laura Sandys) said in a previous debate—is that even if we accept that there is no way of avoiding the cost of the last years of life and the fact that as people get older their maintenance gets more expensive in terms of calls on the NHS, there is a case for considering whether we should do some serious number-crunching to re-engineer social care in order to sharpen up and prioritise interventions, as we have seen with dementia and arthritis. We do not know at this stage what the true benefits of that could be. I am not quite sure what I mean by re-engineering social care even as I say it, but we need to find out what it means and try to implement it in order to defray the costs.

Virendra Sharma: Thank you, Mr Deputy Speaker, for calling me to speak in this important debate.
	I am often contacted by my elderly constituents and their families about social care and its funding, and I can tell the House that it is a massive worry to many of them. While I welcome many of the “in principle” recommendations in the Government’s White Paper, their lack of commitment to reforming the long-term funding of social care means, in effect, that they are kicking this urgent reform into the long grass. Dilnot recommended capping social care contributions at £35,000 and increasing the means-tested savings figure to £100,000. Supporting that in principle is all well and good, but the fact that the Government are not proposing anything specific until the 2013 comprehensive spending review and not implementing anything this side of the general election means that thousands of my constituents will continue to face anxiety about the potential cost of their social care and a substantial loss of their lifetime savings. One in 10 of them will face catastrophic social care costs of over £100,000. That is not acceptable and shows that the Government are out of touch and ducking the issue.
	Social care funding is in crisis. Councils across the country have been forced to cut £1 billion from social care. In Ealing, the Labour council has had its overall budget cut by 30%. With a substantial proportion of its budget being spent on adult social care, it is struggling to protect the most vulnerable, who depend day in, day out on the social care that it provides. It has found 70% of the £85 million that it must cut over four years from efficiencies and has cut a smaller percentage from adult social care to try to protect the vulnerable.
	The spend on social care is decreasing while the number of elderly people in need of social care is increasing. The Local Government Association recently released a report on local government financing that made it clear that with the elderly population and the cost of social care both increasing, unless the Government reform social care funding urgently, by the end of the decade, councils will be able to pay only for social care and all other council services, such as refuse collections, will have to stop. That is not a sustainable situation for social care or for other council services. The Government cannot afford to do what they have done in this White Paper. They have not grasped the financial nettle, but have kicked social care funding into the long grass.
	One action that the Government could take immediately would be to use some of the £1.7 billion underspend from the NHS—£1.4 billion of which has been returned to the Treasury—to tackle the funding crisis in social care. Labour is sensibly calling for £700 million of that underspend to be given to councils immediately to tackle the crisis in social care funding. That would be a significant step that would help my constituents who have social care needs. The need for a long-term funding solution is critical. I hope that the Government will engage urgently in all-party talks so that a solution can be found without further delay. I therefore support the motion.

Margot James: I will start my contribution with some points that I wanted to make earlier in the debate about the origin of the problems.
	I accept that there are severe problems with adult social care. I do not know where the hon. Member for Leicester West (Liz Kendall) got her figures about the last Government’s record on adult social care spending, but according to local government figures, between 2004 and 2010, spending increased by 0.1%. Meanwhile, the population of over-65s grew by 7.7% and the number of over-80s by 11.6%.

Liz Kendall: I am grateful to the hon. Lady for being more generous with her time than perhaps I was. I got my figures from an independent assessment of Labour’s record in Government that was produced by the King’s Fund before the last general election.

Margot James: I am grateful to the hon. Lady for clarifying that. According to local government statistics, in the six years up to 2010, the spend was flat, and I have mentioned the demographic pressures. Interestingly, the same analysis states that over the same time, NHS expenditure rose by 27%, expenditure on the police rose by 20%, and even expenditure on schools rose by 12%.
	A picture is emerging of the deprioritising of adult social care under the last Government. That is the origin of the problem that we are debating. That is what gave rise to the restrictions of the eligibility criteria for care. Long before this Government came to office, many local authorities started to restrict eligibility to those in moderate need of care and then to those in critical need of care.

David Anderson: Will the hon. Lady give way?

Margot James: I will give way one more time.

David Anderson: I appreciate it.
	May I suggest that in criticising the last Government, the hon. Lady needs also to look at the record of the Government before that? Throughout the 1980s and 1990s, the social care and health service budgets were drastically reduced to a degree that was an embarrassment to this country.

Margot James: I welcome the hon. Gentleman’s intervention, but I will move on to the present day, relevant though the NHS and social care budgets of 20 or 30 years ago no doubt are.
	We are beset by problems, although I was pleased to hear the Minister confirm that according to ADASS, social care spending has gone down by just 1% in the past year. Given the incredibly difficult economic situation that we are in, much of which we inherited from the previous Government, that is an achievement. However, we do have problems.
	People value their independence, and most older people want to stay in their own home. With the right support, many can. To a large extent, the White Paper proposals will provide the support that is needed to enable more people to stay at home. Carers are a vital source of people’s ability to maintain their independence at home, and the 5 million carers who do an incredibly important job in our country do not get enough support at the moment. I welcome the extra money that is being put towards enabling them to have respite, because carers tell me that a break is what they need first and foremost. I am sure that no amount of money would
	ever be enough to give them the breaks and support that they need, but at least the White Paper proposals will provide some support.
	Many people do not realise that social care is means-tested until they get to the point in their lives at which they need it. That means that we need more information to be available. We need to be honest with people about what is possible, what is available and what is not. All Governments are guilty of putting the best picture forward, which is sometimes misleading. I applaud the Government’s decision to commit £32.5 million to improving information, but perhaps I can make a plea on behalf of some of my older constituents: that investment should not all be online. Many older people do not communicate in that way, so we must allow for some leaflets in GPs’ surgeries, libraries and day centres, and for other traditional forms of communication. Otherwise, we will make older people who do not engage with new media even more dependent on other people to get information for them.

Fiona Bruce: Will my hon. Friend give way?

Margot James: No, I promised not to take any more interventions, because I know other Members want to speak.
	Then there is the dreaded assessment. Older people often try hard at their assessment to suggest that they can do more than they really can, especially when their carers are present. At the moment, assessments are conducted inconsistently not just around the country but within communities—it depends on who conducts them. I applaud the initiative to make them far more universal and consistent. The Dilnot proposal of making them portable around the country is certainly a huge step in the right direction.
	As Members of all parties have indicated, the quality of care needs to improve. I welcome the emphasis on dignity and respect that runs through the White Paper. It is important that we have better training for care workers and an end, if possible, to the terrible business of contracting by the minute, which flies in the face of dignity. I quite agree with other hon. Members that it is impossible to get an elderly person out of bed and dressed in the amount of time that is allocated these days.
	Dignity and respect are at the heart of a good-quality care system, and I am pleased that that has been given the prominence that it deserves in the White Paper. Of course we would like to do more, but I applaud the Government for making a very good start and, if I may say so to Opposition Members, they have done so within two and a half years of coming to office, which is a great improvement on the previous Government, who took 12 years before they got round to the same point.

Nicholas Dakin: Adult social care is probably one of the biggest, if not the biggest, challenges that we as politicians and policy makers face. We have heard from thoughtful contributions from Members on both sides of the House explaining why it is so difficult. If people are fortunate they never need to access adult care. If they are unfortunate they do need to do so, or members of their family do. As we heard from the hon. Member for Southport (John Pugh), it can be cruel
	lottery. One of our purposes should be to minimise the extent of that lottery and maximise entitlement and support for all individuals.
	One of the most humbling experiences I have had since becoming Member of Parliament for Scunthorpe was going to visit a constituent in his home last week on this very issue of care and support. He is a similar age to me. When he was younger, near the end of his training in the medical profession, he went out into the sea and suffered a terrible accident. As a result, he was paralysed from the neck down. Since then, he contributed to society in a number of different ways. He retrained in higher education until he was advised by his GP to retire because if he did not, in the GP’s words, “the wheels would come off” and he would no longer be able to contribute to society.
	After going to see my constituent, he wrote to me—this is about individuals and real people’s lives—about the publication of the draft social care bill:
	“I have just been reading the latest on social care funding on the BBC website—it would seem that meaningful cross-party dialogue re Andrew Dilnot’s recommendations has broken down and that the government wants to put decisions off until the spending review late next year.
	My suspicions about kicking into the long grass appear justified!...I have already contributed over £60000 towards my care package and seem to be paying more and more each year—despite the fact that North Lincolnshire council reduce the value of my care package every time there is a review.
	My condition has not improved. I am, in fact, starting to suffer more and more of the long term complications that inevitably hit ageing tetraplegics.”
	The worry and concern are there. When visiting my constituent in his home, I observed that the people who were providing the care were brought in at his expense. Resources were not adequate, because that cost was being taken out of his small pension from working in higher education, which went up by 5% a couple of weeks ago, although the contribution to North Lincolnshire council went up by 25%. What is the incentive to do the right thing in difficult circumstances when those sort of things happen?
	What I have described was additional care. The core care was provided by my constituent’s mother, who was in her mid 80s, and his sister, who travelled for two and a half hours to spend half the week helping to care for him. As politicians, we need to step up to the plate. It is about leadership—cross-party leadership—and being able to do the right thing for people, such as my constituent, who suffer misfortune. Had that misfortune occurred, as he said to me, in a car crash, he would have received insurance compensation, which would pay for his care package. Because it took place in a situation of utmost tragedy—nobody was responsible for it, but it was a total misfortune—there is no underpinning support from the state, which should properly protect him and his family from having to pay more and more money. My plea is for us to show the leadership across the parties—

Nigel Evans: Order.

Sarah Newton: I am delighted to follow the hon. Member for Scunthorpe (Nic Dakin), as I completely agree that this issue is
	about leadership. Some of my hon. Friends alluded to a better-tempered debate, such as the Back-Bench business debate, to which all parties made thoughtful contributions, based on a great deal of expertise from different walks of life—whether from people in the medical profession, those who had spent their life in social services or those who had a personal point of view from being a carer. We heard some heartfelt contributions in that debate, so I think we are united in the desire to do something about this issue.
	What I have found deeply disappointing about today is the fact that this debate was called in the first place. There was significant and genuine desire by this coalition Government to solve once and for all this problem that everyone agrees needs to be solved. Everyone agrees that it needs cross-party support—for reasons that are obvious to anyone sitting in the Gallery or watching this evening’s debate and to all the various voluntary organisations that have been very substantially misquoted or very selectively quoted this evening. There is a unity of purpose, but it is not being served by the Opposition who are tabling Opposition day debates, falsely dividing the House.
	If the Opposition were to put their efforts into working closely with the two parties that form this coalition to come to a sensible solution, I believe that measures would be in the White Paper, but we are still seeing sledging and negative comments from Opposition Front-Bench Members as we have seen all day. It is deeply disappointing that the Opposition are so thoroughly letting down the people whom they claim they represent. I do not believe it is too late, and I really urge them to get back to the table and to be more positive about the steps that the Government are taking—[Interruption.] Here we go again; I cannot even finish a sentence without Opposition Members chuntering.
	The fact is that I worked very closely with a number of Opposition colleagues. Various Members have talked about the very good work we did in the inquiry led by the all-party group on local government that looked at this issue. There was an all-party agreed proposal that identified many measures—which the Government have picked up in the draft White Paper—that we can achieve together. The effort should be focused on what we agree on, so that we can offer the reassurance that is needed by the desperately worried people all around the country that have been quietly identified this evening. People are worried not only about the social care system now, but the social care system in the future. We should be reassuring these people and giving them hope that this House has the necessary combined will and determination. I do not think any of us want to face the electorate at the next general election saying that this problem has not been solved.
	As to the timetable, yes, I would love to be able to stand here today and congratulate the Government on finding every penny to fund a long-term solution. If we can get the cross-party talks into gear in September, we should be able to put in place the mechanism that, as confirmed by the Secretary of State, could be built into a Bill and put before Parliament. When all parties have agreed on how this is to be funded—as many people have rightly said, it will cost billions of pounds every year and we are in a very difficult financial situation, so
	all parties must agree on how those billions can be found—there is every possibility that such a Bill will get through Parliament and, when next year’s comprehensive spending review is developed, the money will be found.
	Yes, it is frustrating if we have to wait another year or 18 months. Before I entered the House, I spent the best part of my adult life working for Age Concern England and for the International Longevity Centre in the UK, coming up with solutions that previous Governments certainly kicked into the long grass, so this is our best hope in a generation.

Heidi Alexander: I respect the hon. Lady’s work on this issue, but does she recognise that there is almost universal agreement outside the House that the big disappointment is that there were no proposals last week on how, in the longer term, we provide the funds that we all want for care for the elderly and those with disabilities?

Sarah Newton: I accept that there is genuine disappointment, but people equally understand that all parties in the House must be committed on where the billions of pounds each year will come from, so that the proposals are sustainable for the long term, and so that people can save and invest without fear of the rug being pulled from beneath them.
	The proposals are a sticking plaster—there is not doubt about that—but if only people could hear the facts, they would appreciate that more money is being put into the system while the problem is being resolved for the long term. It is not true that all councils are cutting back. Cornwall council has not cut its adult social care. It is working in extremely innovative ways with the NHS and the voluntary sector to ensure that services are improved. I do not accept the shroud waving from Opposition Members, who say that every part of the country is in crisis.

Richard Graham: My hon. Friend has a high interest in, and knowledge of, these matters. Does she agree that counties such as hers and mine—Cornwall and Gloucestershire—that prioritise adult social services precisely because of their ageing populations, are helping to find a solution to the problem, which is so badly needed by constituents all round the country?

Sarah Newton: I agree. I encourage people to read the good report published today by the all-party parliamentary group on local government, because it contains good examples from all over the country of how proper integration of social services with housing and the NHS is beginning. There is every possibility, as a result of HealthWatch and the health and wellbeing boards, that such integration innovation will deliver the joined-up services for families and carers that will lead to an agenda focused on public health and the prevention of the problems that lead people into acute settings such as A and E and hospitals. People currently end up in such settings far more than they need to.
	I am confident that, in a years’ time, hon. Members on both sides of the House will come here to share best practice from those parts of the country that grasp the opportunities of the Health and Social Care Act 2012 and make the most of the changes. We can then encourage other parts of the country that do not prioritise those
	matters to do the best they can for older people and carers in their societies. All hon. Members want them to have higher-quality and better care so that they can live in dignity for the rest of their lives.

Kelvin Hopkins: The hon. Member for Southport (John Pugh) was kind enough to say that people of a pensionable age can sometimes make useful contributions. He is very kind to me—I am the only Member of a pensionable age to speak in the debate. I am 37 in my mind, but with a son of 42, that is rather unlikely.
	The Government have failed at the core of the White Paper, on the question of funding. This is about money, not leadership or consensus or making nice words in the Chamber. I am very pleased that Labour Front Benchers have accepted Dilnot. His proposals are not perfect, but he goes a long way to proposing a free national care service, which my hon. Friend the Member for Blaydon (Mr Anderson) and I want.
	I know Andrew Dilnot well—he is a fine, highly intelligent and compassionate man. He went to great lengths to tailor a precise scheme that could be accepted by the Government, but at the last minute, they have buckled and not committed to it. The problem is the Treasury—the worst Government Department of all. It has failed the country over and over again with terrible mistakes. The European exchange rate mechanism destroyed the credibility of the Conservatives, but the Treasury has done lots of other bad things. It is a dreadful Department. I hope that Ministers now tell me how wonderful it is.
	There has been almost no mention of the royal commission on long-term care from some 14 years ago—I think my hon. Friend the Member for Blaydon mentioned it—which recommended free long-term care, which is precisely what he and I want. However, the Government at the time—they happened to be a Government I supported—could see that the report was going to be unanimous, so they slotted in two people at the last minute to ensure that it was not unanimous, and from that point onwards they hung on to the minority report of those two members. It was a bit of a disgrace, and I made that point strongly. I tabled an early-day motion in the 1997 to 2001 Parliament calling for implementation of the royal commission’s recommendations, which was signed by more than 100 Members of the House at that time, and in the 2001 to 2005 Parliament I tabled another early-day motion saying the same thing, again with the same sort of support. I also have the support of the National Pensioners Convention—a body with which I am closely associated—which also wants free long-care on the same basis as in the NHS.
	In Scandinavia they do it. Indeed, what I have always wanted my party to do—as well as the others, but particularly mine—is to move in the direction of Scandinavia, not the United States of America. If Members read the book “The Spirit Level”, they can see that the civilised societies—where people are happier and all sorts of social problems are lesser—are in the Scandinavian- style countries. The worst end of the spectrum is in America, and we have been steadily moving towards the American end, not the Scandinavian end.
	In the end it is about cost and this word “affordability”. We choose what is affordable. It is not written in stone: we can choose to make things affordable, and we can
	choose to pay for them by progressive taxation—if we wish. It is a political choice. People say, “Oh, well it’s not affordable.” However—I have told this story many times—I remember that when my children were young, if they asked for a second ice cream, my wife would say to them, “Mummy can’t afford it,” when what she was really saying was: “You can’t have another ice cream.” Of course she could afford it. We can afford to pay for free long-term care too, but we choose not to—so far. I hope to persuade my side at least to commit to it in time.
	The extra costs of Dilnot would initially be £2 billion a year. That is the equivalent of 0.5p on the standard rate of income tax. I have put this to many people in meetings and asked them, “What would you choose: the threat that your home would be taken away, with no equity to hand on to your grandchildren, or an extra 0.5p on the standard rate?” Without exception, they say 0.5p on the standard rate. Of course, we do not have to do it that way, because there is plenty of cash in the tax gap, which is estimated to be as much as £120 billion a year, or even more. If we collected a tiny fraction of that—one sixtieth—we could cover Dilnot’s proposals; and, if we have to have a bit more, let us squeeze the tax gap a bit further. However, since Margaret Thatcher’s time as Prime Minister, we have seen the standard rate cut by 5p, which is 10 times more than the cost of Dilnot, so do not let us pretend that it not affordable. We choose not pay for it, because we think—or some people think—that low taxes are better or that letting tax evaders and tax avoiders get away with it is better than looking after elderly people in great need.
	We are also committed, apparently—I understand that this goes for both sides of the House—to the idea of owner occupation, but we are actually seeing the gradual erosion of owner occupation, particularly by poorer people having their houses taken away when—

Nigel Evans: Order.

Daniel Poulter: It is a great pleasure to follow the hon. Member for Luton North (Kelvin Hopkins). I commend him for his ability to get Europe into almost every debate we have in this House. I am not sure whether his sums quite added up at the end of his speech, but it is commendable that we have seen a commitment across the House this evening to improving the dignity and quality of elderly care, which is something I am sure we would all like to see.
	All previous Governments have taken steps in that direction, but I believe that the White Paper and the draft Bill that this Government have brought forward represent the most significant steps towards improving dignity in elderly care for a generation. The in-principle support for Dilnot and the Dilnot proposals is a good recommendation, and it needs to be considered in the context of whole-government spending at the next spending review. However, for the first time there has been an in-principle agreement by a Government that social care is one of the most important issues and challenges facing our country. How we are going to provide dignity in elderly care—high-quality care in the community—is a clear priority for this Government, and that should be commended.
	I want to outline some of the real challenges that face people who are in receipt of social care, particularly the frail elderly. The hon. Member for Blaydon (Mr Anderson) pointed out that it can be difficult to distinguish between NHS care and social care, because they often involve exactly the same things. They include supporting the activities of daily life that we all take for granted, such as washing, dressing, getting in and out of bed or the bath and going up and down stairs. Those are the kinds of things that we mean when we talk about providing high-quality social care, and this Government have put forward strong measures that will make it much easier to provide such care for the people who most need it.
	The White Paper and the draft Bill provide for support for carers, and for improving the personalisation of care, which is particularly important for younger people in receipt of social care, as the hon. Member for Scunthorpe (Nic Dakin) said. Respite care is also recognised as an important means of better supporting carers, giving them a break from the hard work of looking after people and ensuring that the role of carers is properly supported. The proposals also include a commitment to portability of care, and to a universal care assessment.

Glyn Davies: I raised the issue of portability with the Secretary of State last week. It is crucial that a debate should take place about what we are doing here and what is happening in Wales, as this is a devolved matter. There must be close liaison between us. I understand that the initiative must come from the Welsh Government but, without that liaison, people will fall between the two countries.

Daniel Poulter: My hon. Friend makes an important point. Social care and NHS care do not recognise county borders, which is why portability is so important. They certainly do not recognise the boundaries between England and Wales or between any other parts of the United Kingdom. We have devolved responsibility for the NHS, and the fact that there are different funding priorities in the different parts of the UK, with the Government in England supporting investment in the NHS and the Labour Administration in Wales cutting NHS spending, highlights the importance of my hon. Friend’s point. I am sure that the Minister will be able to reassure us that the coalition Government are taking steps to ensure that portability can take place across those borders wherever possible.
	The White Paper also contains a commendable commitment to improving integrated care and ensuring that more joined-up working takes place between the NHS and social care.

Sarah Newton: Would my hon. Friend like to comment on some of the Opposition’s assertions that the efficiency savings from reductions in management levels in NHS are not being put back into front-line services to enable integration, and that they are somehow being siphoned off to the Treasury? I do not believe that—

Nigel Evans: Order. I must ask the hon. Lady to turn round so that the microphone can pick up what she is saying. I know that she is finding that difficult, but she should be heard by everyone in the Chamber.

Daniel Poulter: I thank my hon. Friend for her intervention, and I agree with her. The Government are making a clear commitment to encouraging integrated care and to putting savings made in the back office back into the front line of NHS care. Many billions of pounds have already been committed, and there is more money in the draft Bill to encourage better integration between the NHS and social care services.
	As the Minister of State said, it is important to shift the emphasis away from crisis management and towards preventive care. The focus on housing as part of the integrated care system is important. My hon. Friend the Member for Congleton (Fiona Bruce) made the point that, far too often, older people fall over and injure themselves as a result of poor lighting or a lack of handrails in their homes, ending up in the accident and emergency department, when better lighting and preventive care in the home would have provided a much more effective way of looking after them properly, as well as saving the NHS and social care a lot of money. That key commitment to more integration between the NHS, providers of housing and social services providers is a fundamental ingredient of the way in which we can improve the day-to-day quality of adult social care, while also saving a great deal of money, which can be spent on improving care for everyone else.
	Finally, let me talk a little about funding. The Dilnot proposals have been agreed to in principle, and I hope that the Opposition will at least give the Government some credit for the fact that there has been a once-in-a-generation attempt to deal with this issue. It is not good enough to say, 13 years into an Administration, “Three weeks before the general election, we will publish a White Paper.” No one could consider that a serious commitment to tackling the challenges that we face.
	The way forward now must be the cross-party working that we all believe is desirable. That means that all parties must work together and support the Government’s White Paper, support day-to-day improvements in care for older people, and support the agreement in principle to the Dilnot proposals that the Government have presented.

Julie Hilling: While we sit here discussing this issue, families will be sitting in their living rooms or around hospital beds trying to decide what to do for their loved ones. Can they stay in their own homes? Will someone be able to deliver 24-hour care? How long will the situation continue? What will happen when the money runs out? What should they do for the best? While we sit here listening to the Minister telling us that we will sort things out in the future, families—now—are making the most difficult decisions of their lives.
	I want to talk about the reality for my constituents, and to plead with the Minister to work with all the political parties in this place to find a long-term solution to the growing crisis of adult social care. It has to be a long-term solution: it has to be a solution that will last for many years, whoever is in government, and we have to find it now, not after the next general election. Old age happens only once to each individual. It is not something that we can return to and do better next time.
	We cannot just look at residential care; we must also look at the systems that keep people in their own homes, and allow them to lead fulfilling lives and live in dignity. The present situation is dire. Bolton council has had to cut £15 million from its budget for adult social care, which means that it can no longer give support to the 536 people aged between 18 and 64 and to the 1,312 people aged over 65 who have moderate needs.

Roberta Blackman-Woods: Does my hon. Friend agree that we have heard nothing from the Government this evening that demonstrates that they have any idea of the funding crisis that is hitting a number of local authorities throughout the country? There is no urgency at all in the Government’s actions.

Julie Hilling: Yes. The cuts faced by northern local authorities in particular are dire. Bolton will have to find £100 million worth of cuts during the current Parliament.

Sheila Gilmore: Does my hon. Friend agree that it simply is not good enough to express—as the White Paper does—concerns about such matters as short periods of care time, or the fact that some carers are not even earning the minimum wage, if there is no way of making things work financially? I do not believe that councils have chosen 15-minute slots deliberately; I believe that they have done it in order to save costs and make efficiencies. Similarly, there are carers who have to pay for their own travel.

Julie Hilling: We have to realise that we are facing a crisis now, not a crisis in the future. People in our constituencies are suffering daily. A young man in my constituency who has learning difficulties and has relied on carers to help him with his everyday life will now see his carer only once a week. Contact with a carer is the only contact that many such people ever have with another human being, and that contact is now going. It is truly a false economy. This low level of care for people with moderate needs is what keeps them in their homes, keeps them healthy, and stops them ending up in residential care prematurely. Bolton is managing to maintain substantial and critical care, but it will have to find £34 million in cuts over the next two years, and it is worried that it will have to join other councils in only providing critical care.
	Paying for home care is a huge worry. The average cost is £13.61 an hour, but it can be a great deal more; in Brighton and Hove, carers cost £21.50. It is not unusual for people paying for care to have to find more than £10,000 a year to cover that cost. That spending needs to be taken into account if we are to have caps over the whole amount. Many Members will know that my mother has been in and out of care over the past 12 months. We have spent £20,000 since October on her care.
	The cuts to local authority budgets are affecting other support services, and the consequent cuts to the voluntary sector are having dire consequences. The voluntary sector provides luncheon clubs, social activities and carers groups, all of which are under pressure or at risk.
	Horwich visiting service in my constituency has lost funding and can no longer employ its part-time co-ordinator. That was the person who recruited volunteers,
	sorted out the police clearance, provided training, ascertained the needs of clients and supported the volunteers. The volunteers will continue to visit the elderly and disabled people with whom they are currently in contact, but it will not be possible to recruit new volunteers or take on new clients.
	The fees local authorities pay to care homes is also an issue. There has been a significant real-terms cut over the last two years. That inevitably impacts on care. It also means self-funders are charged more in order to subsidise the costs of council-funded residents.
	The choice of home is another huge concern. The other day, I was speaking to one of the police officers on the parliamentary estate. He told me his mother was in a care home. He and the family had chosen a home that suited her needs and they had sold her house to pay for the care, but now the money is running out and he does not know whether the local authority will pay the care home fees, whether his mum will have to move or whether the family will somehow have to pay the additional costs. If the cap is ever introduced, that will be too late for him, but he still needs to know that the care costs will be met in future.
	The needs of the elderly and disabled do not move in a straight line. Some people may need to go into care for a period of time, such as when recovering from an illness or an accident, but, with support, be able to return home. However, we were told that after six months my mum would have to sell her flat to pay for her care. In fact, after eight months in a care home, she has returned to her own flat. That shows that people do not move in a straight line through the system. Decisions should not be taken on the basis of cost alone; they should be taken on the basis of needs, too.
	Let me conclude by reading out a comment from a constituent of mine called Amy:
	“Alongside the funding crisis there is also a huge injustice in the way we pay for care. This includes the dementia tax, where tens of thousands of families are left to pay all their care costs whilst other terminal conditions are paid for by the NHS.
	The significant cost of care means many carers face financial hardship and are often forced to give up work.
	We need reform to build a fair and sustainable care system which delivers dignity, independence and peace of mind.”
	Amy is right. We need to get on with this. We need to find a solution where people’s needs are taken into account, and where people do not live in fear for both themselves and their families. We need to find a solution to this problem that all of us can live with, and that cares for people who are in need in our society.

Several hon. Members: rose —

Mr Speaker: Order. The Opposition Front-Bench speech must start at 9.40 pm, so the hon. Member for Blackpool North and Cleveleys (Paul Maynard) has a tiny window of time in which to make his contribution.

Paul Maynard: I shall be very brief then, Mr Speaker. I have just two minutes.
	When we talk about social care, we tend to spend most of our time discussing the elderly. I want to say a few words about young disabled people, however, who
	benefit from social care, and who need to have a voice in this debate. I chair the all-party group on young disabled people, and we have been discussing many of the key issues. Last week, we discussed housing, for example. I welcome the money proposed in the White Paper for improving housing for the disabled, but may I sound a note of caution? At present, too many wheelchair-adapted houses are not going to those who need them—people in wheelchairs. It is all very well constructing these houses, but we must get the allocation policy right, too.
	I welcome the transition funding, but I have a plea to make on that. There is a concern that there is a cliff-edge at the age of 18. For many families it is, as it were, a gradual cliff-edge. Things start to decline at 14, so the care package they get at 18 might not be the appropriate one they need as an adult. May I ask the Minister to look at that issue closely?
	I welcome the introduction of portability, as that is crucial. I know that the Opposition brought similar measures in when in government, but we are taking this further. It is far more important for younger disabled people than it is for those who are elderly. We talk a lot in this Chamber about social mobility. One of the main hurdles for young disabled people who wish to go to university is the great fear that when they get there they will not have the same social care package as they had when they were at home with their parents. That is the main fear they face; it is what keeps them at home and means that they do not take full advantage of the educational opportunities on offer. I will stop there.

Diane Abbott: No family in the land is untouched by the challenges of social care. Families up and down the land who will watch this debate or read about it know that if social care is not an issue for them today, it may be an issue for them later. Labour Members therefore think it is important that it is spoken about not in policy wonk or accountancy terminology, but in terms of people. That is because it is an issue about people, be they the elderly, the disabled, the young disabled, about whom we heard eloquently just now, the carers within the family or the tens of thousands of men and women who work as professional care workers, about whom my hon. Friend the Member for Blaydon (Mr Anderson) talked so eloquently earlier.
	Let me say from the outset that the Opposition accept that this is an issue about which we could have done more. Social care and the challenges it poses in the 21st century are unfinished business for Labour. However, it is not true to say, as some Government Members have unfortunately done, that Labour was wholly inactive on the issue of social care. We heard from my hon. Friend the Member for Leicester West (Liz Kendall) about all the steps we took and the innovations we made on issues associated with social care. To say that we were totally inactive is quite wrong and is merely party political point scoring, but it is true that we did not grasp sufficiently early the political nettle of how social care is to be paid for. That is why, from the very beginning, we offered talks and entered willingly into them, and why we remain willing to resume talks, so long as Ministers are acting in good faith.
	Social care is an issue for families up and down the land. Government Members have said that people have to understand that they are going to sell off their homes, but the point about that is that homes are not mere bricks and mortar. These may be the homes that people came to as a young married couple and where they brought up their children; these are homes freighted with memory, emotion and family life. It is too easy to say that people have to be ready to sell off their homes. This is about people; it is not just about figures on a piece of paper.
	Social care is also quintessentially an issue for the squeezed middle, to use the phrase of my right hon. Friend the Member for Doncaster North (Edward Miliband). The very poor will not have to meet their own costs, although there are still issues to address about standards of care, and the cost of care is not a problem for the extremely wealthy. This is an issue for the squeezed middle; it is an issue for people who, perhaps through years of struggle, have a home and assets and now see the frightening possibility—this is particularly the case for the elderly—of those assets being drained away because of a system that is not yet under control.

Glyn Davies: rose—

Diane Abbott: I am afraid that I will not be able to give way, because I want to leave sufficient time for the Minister to make her remarks.
	We also have to address the issues of dementia and Alzheimer’s. They are largely dealt with as social care issues but in fact they are an increasing challenge for people as they grow older.
	The Minister called social care Bevan’s orphan and I think that that is a little unfair. The world we face today is very different from the world of William Beveridge and the framers of the first national health service. People live much longer and do so with all sorts of long-term conditions, whereas changes in the role of women mean that there is no longer a vast, mute and hidden army of carers. There are also issues with dementia and Alzheimer’s.
	The Opposition want to be collaborative rather than party political, but I would be failing in my responsibilities if I did not draw to the attention of Ministers the one message given to my colleagues and I as we have gone up and down the country talking to local authorities about the new public health arrangements and social care. Those in town halls, whether they are Labour or Conservative-led, have said that local authorities are under unprecedented financial pressure. Some of the things we heard from Ministers seemed to suggest a certain carelessness about or unwillingness to face up to the financial pressures that mean that local authorities are making real decisions that are affecting real people and real families. Ministers heard what local authorities are trying to do to make the money stretch. On the one hand, there are more stringent criteria, so people need to be in greater need to get social care at all, but on the other hand, they are squeezing the money and the standards. That is the only way it can happen.
	If I could say only one thing to Ministers, it would be that they should listen not to the Opposition spokespeople or to Labour councillors but to their own Conservative councillors, who are trying to make them address the
	scale of the crisis that they face. They are very alarmed—we know that they are—that Ministers appear to be poised to place additional responsibilities on them without any ideas of how to provide funding.
	I remember what the Prime Minister told this House in February 2010, speaking about social care. He said:
	“What we want to know is: where is the money coming from?”—[Official Report, 10 February 2010; Vol. 505, c. 904.]
	I have to say that councillors and families up and down the country, as well as Members of this House, want to know what is behind the fine words and what Ministers will do to fund the proposals outlined in their White Paper.
	Precisely because I do not want to be party political, I will refrain from talking about the Conservative party’s party political broadcast on the death tax and the posters that said:
	“Now Gordon wants £20,000 when you die. Don’t vote for Labour’s new death tax.”
	I am not a party political person, so I shall leave that. I shall put it to one side.
	We support Dilnot in principle, but we are a little concerned about the Secretary of State’s pick-and-mix approach to the recommendations. We are worried that although the White Paper reads well, it makes too many vague commitments. I would be grateful if the Minister could give me an answer on the question of loans, in particular. On that question, as she will be aware, the 1999 royal commission—sadly, we did not address the issues of funding that it raised—said that
	“there would need to be an initial outlay of potentially between £1bn and £2.8bn…the scheme would be complex to establish, and to administer, probably very expensive initially and would leave the state with an uncertain liability. If Local Authorities administered it, they might be left with a complex burden of assets which would differ greatly from one part of the country to another. The Commission consider there little overall benefit to be gained from such a scheme.”
	I would be grateful if the Minister could tell me —[ Interruption. ] It is a deferred payment scheme at the discretion of local authorities—[ Interruption. ] We want to know how the Government will fund the upfront costs and about the levels of interest. Members will appreciate that elderly people, in particular, are very concerned about issues of debt. On that and on a range of other issues, we are waiting for a little more detail from Ministers. They can sit on the Front Bench and make party political remarks, but that is no help to families throughout the country who are worried about how they can fund social care in the future. It is no help to local authorities, which say that in a very few years the cost of social care will have inflated so much that they will not be able to meet other needs from their budget.
	There are many things in the White Paper that we welcome, not least because many of them were in the White Paper introduced by my right hon. Friend the Member for Leigh (Andy Burnham) on building a national care service. We say to Ministers that it is easy to score points. It is easy to talk about what could have been done in the past, but we need to meet the challenge of how we care for our elderly, our disabled and our young disabled. That is the challenge that the nation is facing now. The White Paper reads well, but Age Concern and all the stake-holders are asking how Ministers will
	fund it. We stand ready to enter talks. We stand ready to work with Ministers. All we ask from Ministers is that they act in good faith.

Anne Milton: I was heartened by some of what I read in the motion tabled by the Opposition. Welcoming the measures laid out in the care and support White Paper was a good start to a process that will be immensely easier with genuine co-operation and communication. However, the speeches from the Opposition Front Bench were partisan and contained no acknowledgement that for 13 years they did nothing. The hon. Member for Leicester West (Liz Kendall) seems to have amnesia. Cheap party political squabbling is not attractive. I remind the hon. Member for Hackney North and Stoke Newington (Ms Abbott) that she was very political by trying not to be political. I remind her also that 40,000 people a year had to sell their homes to pay for their care. It reflects badly on her and on the House and does nothing to improve the lives of service users, carers and staff. A White Paper seven days before the general election announcement counts for little.
	Care has to be funded in a way that is fair on service users and fair on the taxpayer. We agree with Dilnot that financial protection through capped costs and an extended means test are the right basis for any new funding system. Given the extra public spending that will be involved, we need to consider that alongside other priorities. An issue that has been raised throughout the debate is the funding for the means-tested system. The right place—the responsible place—to consider that is in the course of the spending review and I do not intend to pre-empt that tonight. I draw hon. Members’ attention to the progress report. Many of the answers to the questions that they raise are included in that. The hon. Member for Hackney North and Stoke Newington would do well to refer to figure 4 in the report.
	We have allocated an extra £7.2 billion to improve care and support as part of the spending review. That comes as part of what we know is a tough settlement for local government. If spent well, it will go far and will help local authorities maintain people’s access to care and support. The recent report from Demos and Scope shows that this can be done, and that reduced funding does not have to mean a reduced service. By putting more into reablement services that help people regain their independence, for example, or by supporting people to live in the community instead of in expensive residential care, local authorities can provide the best standards of care while saving money.
	My hon. Friend the Minister of State mentioned the £32.5 million for better online services and traditional communication methods to help people see what services are available, whether their care is paid for by them or by the state. Likewise, there is an additional £200 million for specialised housing. That additional money more than pays for the White Paper proposals leading up to the comprehensive spending review. As my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) said, the issue was ducked repeatedly by the previous Government in far more favourable economic times. He also drew attention to the absurd distinctions between health and social care and the need for integration.
	My hon. Friend the Member for Congleton (Fiona Bruce) spoke from the heart about the needs of carers, the £400 million we have provided for carers’ breaks and the end of permanent billing. My hon. Friend the Member for Southport (John Pugh) spoke of the contribution older people make and how to stop the fit becoming frail. My hon. Friend the Member for Stourbridge (Margot James) reiterated the ADASS figures and the desire for people to stay in their own homes. My hon. Friend the Member for Truro and Falmouth (Sarah Newton) spoke with passion and knowledge of the unity and commonality of purpose we need and the divisive nature of the Opposition’s motion. My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) pointed out the huge need to address the needs of people with disabilities.
	These are ambitious plans. As well as setting out a comprehensive package of reform for the longer term, the White Paper announces changes that will make a difference immediately: a national eligibility threshold; proper and meaningful portability; duties to share information to ensure that people can move without losing their care; a focus on housing; provider quality profiles so that people can finally have clear information on the quality of care providers; mandatory adult safeguarding boards; and a requirement to assess carers’ needs and actually meet them—much neglected help and support. It also announces a code of conduct and minimum training standards for care workers so that people know that their care is underpinned by high standards of training and ethics. We will train more care workers, with 50,000 more apprenticeships by 2017, double the current number.

David Anderson: rose —

Anne Milton: The hon. Gentleman should welcome that.
	The White Paper opens for business the new national information website so that people can find out more about all parts of the care and support system. It sets out legal entitlements to personal budgets so that care users, their families and their carers can choose what services they get. There are improvements to the transition to children’s services to adult services. These are big changes, egalitarian changes and, most of all, they will be effective changes. We are also reforming the existing social care legislation through the draft Care and Support Bill. The White Paper is about keeping people well and helping them to take control, get independent and live the lives they deserve with the certainty and security they need to do so with dignity.
	There are times when we, as politicians, need not only to open our eyes and ears to the world outside this House, but to stand in the shoes of those we represent. They do not want to see us argue, squabble and bicker over their lives. On this issue, perhaps more than any other, we need to work together. If we do that, we can improve the system for millions of people, whether they use the services or care for someone who uses them. The system is funded until the next spending review.
	I urge Opposition Members and Front Benchers to put aside party political differences and work alongside us to ensure that we have a system that is sustainable
	not only for this year and next, until the next general election, but for the years ahead. Older people in this country, the carers who support them and people with disabilities deserve that. The White Paper gives us a foundation on which to work, a foundation that has been missing for far too long. In 13 years in government, in favourable economic times, those now on the Opposition Benches did nothing that was sustainable in the long term. We need a foundation that gives us a chance to build a care and support system that future generations will be proud of. I urge the House to reject the motion.
	The House divided:

Ayes 225, Noes 292.

Question accordingly negatived.

Business without Debate

Business of the House

Ordered,
	That, at this day’s sitting, proceedings on the Motion in the name of the Prime Minister relating to the Parliamentary Commission on Banking Standards may be proceeded with, though opposed, until any hour, and Standing Order No. 41A (Deferred divisions) shall not apply.—(Mr Vara.)

Parliamentary Commission on Banking Standards

George Young: I beg to move,
	(1) That a Committee of this House be established, to be called the Parliamentary Commission on Banking Standards, to consider and report on—
	(a) professional standards and culture of the UK banking sector, taking account of regulatory and competition investigations into the LIBOR rate-setting process;
	(b) lessons to be learned about corporate governance, transparency and conflicts of interest, and their implications for regulation and for Government policy;
	and to make recommendations for legislative and other action.
	(2) That Mr Andrew Tyrie be Chair of the Commission.
	(3) That Mark Garnier, Mr Andrew Love, Mr Pat McFadden and John Thurso be members of the Commission.
	(4) That the Commission have leave to join with any committee appointed by the Lords to consider the said matters.
	(5) That the Commission may hold meetings under the provisions of paragraph (4) of this order at any time after the Lords has agreed to appoint a committee.
	(6) That the Commission shall, except as provided for in this order, follow the procedure of a select committee of this House.
	(7) That the Commission shall have power—
	(a) to send for persons, papers and records;
	(b) to examine witnesses on oath;
	(c) to appoint specialist advisers;
	(d) to invite specialist advisers (including Counsel appointed as specialist advisers) to examine witnesses;
	(e) to adjourn from place to place;
	(f) to sit notwithstanding any adjournment of the House; and
	(g) to report from time to time.
	(8) That the Commission shall have power to appoint sub-committees to consider matters specified by the Commission within the terms of this order and a subcommittee shall have—
	(a) the powers in paragraph (7)(a), (b), (e) and (f); and
	(b) the power to invite specialist advisers appointed by the Commission (including Counsel appointed as specialist advisers) to examine witnesses;
	and the quorum of a sub-committee shall, subject to paragraph (12)(b), be one member of this House.
	(9) That the Chair may report to the House an order, resolution or Special Report as an order, resolution or Special Report of the Commission which has not been agreed at a meeting of the Commission if he is satisfied that he has consulted all members of the Commission about the terms of the order, resolution or Special Report and that it represents a decision of the majority of the Commission.
	(10) That the quorum of the Commission shall be two members of this House.
	(11) That, whenever this House shall stand adjourned other than to the next day, any report, Special Report, order or resolution agreed to by, or evidence taken or received by, the Commission, including any under paragraph (9) of this order, may be published or printed under the authority of this House, shall be deemed to have been reported and shall be reported when this House next sits.
	(12) That, when the Commission operates under the provisions of paragraph (4) of this order, the following provisions shall apply—
	(a) the quorum of the Commission shall be two members of this House and two members of the House of Lords;
	(b) the quorum of any sub-committee shall be one member from either House; and
	(c) the power of the Chair to report under paragraph (9) may also be exercised with the Chair’s agreement by a member of the Commission who is a member of the House of Lords.
	(13) That the costs of the Commission shall be assessed by the House of Commons Commission from time to time and shall be paid by Her Majesty’s Government for the credit of the House of Commons (Administration) Estimate.
	(14) That the Commission shall report on legislative action no later than 18 December 2012 and on other matters as soon as possible thereafter.
	(15) That a message be sent to the House of Lords to desire their concurrence.
	On 5 July, the House debated professional standards in the banking industry for a full day and resolved to establish a Joint Committee of the two Houses on that matter. As I said in that debate, I do not think there is any disagreement between the Government and the Opposition on what we need to do, which is to sustain in the UK a strong, vibrant, transparent and more accountable financial sector that commands international confidence.
	The motion before us is the result of negotiation following the House’s decision to establish a Joint Committee. I thank my hon. Friend the Member for Chichester (Mr Tyrie) for the work that he has undertaken while also chairing a very active Select Committee. I also thank Her Majesty’s Opposition. Following the debate, it was essential that Parliament was seen to be acting in the best interests of the public in resolving the issue before it, and that could happen only if the Joint Committee were supported not only by the parties in Government but by the Opposition. I am grateful to those who have added their signatures to the motion.
	I do not intend to detain the House for long. I want to make five points, spending half a minute on each. [ Interruption. ]

Mr Speaker: Order. Before the Leader of the House makes his five points, to which I wish to listen carefully, may I gently say to the House that he should be heard? Any Member should be heard, but the Leader of the House is a very senior Member, and Members should not be sitting chuntering to each other; they should show him some courtesy, which they all learnt at one time.

George Young: As I said, I have five points and will spend half a minute on each one.
	First, the process to establish the Commission is not following the normal process for establishing a Joint Committee. The Commission, if established tonight, will be able to begin its work immediately and to meet during the recess. It is my hope that before the other place rises, it will also establish a Committee of an equal number of members to act jointly with the Commission that we are establishing tonight.
	Secondly, the Commission is being established with powers that are already inherent in our parliamentary system. It will also have the novel power to invite special advisers, including counsel appointed by the Commission, to examine witnesses. I do not think that that will become the modus operandi of other Select Committees, but it will give the Commission the teeth that it needs to carry out its important investigative role quickly and effectively.
	Thirdly, it is proposed that
	“the Commission shall have power to appoint sub-committees to consider matters specified by the Commission”.
	Unusually, the sub-committees will have a quorum of one. I have discussed that with my hon. Friend the Member for Chichester. The purpose is to allow a single member of the Commission to consider a specific issue, for example a technical matter, and to send for papers with a view to informing the wider Commission. That will feed into the Commission’s work and allow it to tackle a broad-ranging subject in a compressed time frame.
	Fourthly, paragraph (13) of the motion directs the House of Commons Commission to assess the costs arising from the Parliamentary Commission to be paid by the Government. As the Chancellor said in the debate on 5 July:
	“I commit to giving it any resources it needs to do its job.”—[Official Report, 5 July 2012; Vol. 547, c. 1136.]
	I hope that that reassures my hon. Friend the Member for Harwich and North Essex (Mr Jenkin), who sought reassurance during our debate on 5 July that the Commission should not raid
	“the staff and resources of other Committees.”—[Official Report, 5 July 2012; Vol. 547, c. 1149.]
	Fifthly and finally, the motion sets a deadline for a report on legislative action of 18 December. That will include pre-legislative scrutiny of the banking reform Bill and any recommendations of the Commission’s inquiry that require a legislative vehicle in order to be implemented. The December deadline will give the Government time to consider any recommendations in time for the introduction of the banking reform Bill, which is planned for January 2013. If the Commission cannot complete all its work by 18 December, we will expect it to report on the other areas as soon as possible thereafter.
	We have in this Parliament the skills, expertise and mandate to do the job. I am confident in the ability of the new Commission to rise to the challenges that confront us and to address the central issue at stake: restoring confidence in the UK banking industry. I commend the motion to the House.

Angela Eagle: Like the Leader of the House, I do not wish to repeat the debate that we had on 5 July. We are in slightly calmer waters, we hope. In that debate, all parties on this side of the House felt that we needed a judge-led inquiry into the LIBOR scandal and wider issues in the banking industry. We did not win the vote so, despite our reservations, we decided to co-operate with the inquiry led by the hon. Member for Chichester (Mr Tyrie). I am grateful to the Leader of the House for his admission that the success of the Commission relies on the Opposition’s support. That gets us off on a better foot than might have been the case.
	There are some novel elements to the motion, as the Leader of the House pointed out, not least the sub-committees of one. We will look with interest to see how that works in a Commission of the size that is proposed, especially given that it is a joint Commission with the other place.
	I am particularly pleased with the assurances that the resources that are needed will not be taken out of House of Commons resources for other Select Committees. I wonder whether the Leader of the House has a view on what amount of resources might be used and whether we will be kept informed as the process goes on. The Opposition are keen that the ongoing work of the Treasury Committee, the primary job of which is to hold the Government to account, must not be badly affected by its members, not least its Chairman, being engaged in other important work, which may have a tendency to take them away from their day job. We will obviously keep a keen eye on the situation, to ensure that the Treasury Committee’s work of holding the Government to account does not suffer as a result of the other duties that the hon. Member for Chichester and other members of the Committee who are to sit on the Commission will take on.
	Having emphasised once again our belief that we needed a judge-led inquiry, the Opposition are happy, given that the vote on that was lost, to co-operate with the hon. Gentleman’s inquiry, and we will watch its progress with interest. If the House divides this evening, we will join the Leader of the House in the Lobby.

Richard Fuller: I rise briefly to welcome the motion and wish all the members of the Commission the best. I recognise the willingness that my hon. Friend the Member for Chichester (Mr Tyrie) has expressed for the Commission’s work to be forward-looking, and I understand that its role will not be to act as prosecutor. However, I give its members this piece of advice. They are doing the people’s work, and the people have an expectation of the review of the financial crisis and the financial services sector. They will not understand the work of the Commission unless this is accomplished: somebody has to go to jail.
	Criminal prosecutions are an essential part of cleansing our financial services sector and moving us forward, to ensure that the City can reassert itself and its reputation not only in the eyes of the world but in the eyes of the British people. That is one of the most important requirements of the parliamentary inquiry, and I leave it to the Commission to consider that comment.

John Mann: It appears that this Commission, which was originally described as a very narrow one, is broadening so that, as the Leader of the House said, it can now look at particular matters with sub-committees of one, and there are suggestions that it should broaden into criminal prosecutions.
	The issues remain as they were, but the evidence is changing and will continue to change. That is the problem with setting up ad hoc committees. Just in the past hour, further e-mails have come from the Bank of England that have some significance for matters that have already been looked at, looked at again and looked at a third time. Those e-mails are significant to what the Treasury Committee looked at the first time, and doubtless information will continue to emerge.
	This is a moving feast, and the problem with a moving feast is that setting a time limit when one does not know what will happen next can lead to a certain momentum, which can be in the wrong direction. The
	problem is not that it is an arbitrary time limit—any time limit is arbitrary—but that it could be an irrational one.
	Tomorrow in the United States, a new court action is being initiated not on LIBOR but on other market manipulation by banks, and specifically a British bank. We will see what happens as that court action proceeds, but simply examining LIBOR, and especially only the one bank in which what has gone on has been partially exposed, rather misses the point about market manipulation by investment banks over the past 10 years.
	Even within the context of LIBOR, we have only just reached the stage of seeing some of the market manipulation that happened, and only in one bank, Barclays, which has received bad publicity. There is far more to be revealed about that, and I am certain that there will be more surprises to come in the next day, week or two weeks. Those surprises may well continue to flow.
	Even in the case of Barclays, the manipulation of LIBOR is one tiny part of the allegations of market manipulation and anti-competitive work. A swathe of evidence is beginning to emerge, and more people are now prepared to speak out about how a range of markets have been manipulated in a range of ways. Derivatives have been used as the basis of that manipulation, but in fact it is much more complex than that. At its heart, as Barclays has said, was the making of a quick profit. In the past two weeks, courts in Canada have specified in a non-LIBOR-related case where the judge has pronounced that it was manipulation for short-term profit on an anti-competitive basis.
	That is just one bank. No one can answer—the question was not answered by the Financial Services Authority today; perhaps it is not in its remit to do so—what the contingent liability is for Barclays. That is a small concern, and of significance to people working for the bank, people who have shares in it, and the wider economy, but it is clear that the largely state-owned banks, not least the Royal Bank of Scotland but also Lloyds TSB, have been doing the same thing. The problem that we will face is not just the issues of criminality that may or may not emerge. Proving a criminal case in any of that is fiendishly difficult—both finding the person who has committed an act and finding a victim so that a case can be taken. If law suits, beginning in the United States but spreading elsewhere, start to succeed, the amounts of money that have been fiddled are so great—because of the instruments that were used—that the British taxpayer may face a huge, unquantified bill, and we do not know when it will arrive. The future of Barclays is somewhat in question.

Mr Speaker: Order. I appreciate that the hon. Gentleman is indulging in scene setting—offering the House the context—but I would politely suggest that he will wish to turn to the proceedings and composition of the intended Committee. If it is helpful to him, I gently remind him, in relation to the motion, that he has 15 paragraphs from which to choose when deciding how to focus his remarks.

John Mann: I thank you for your guidance, Mr Speaker. My initial remarks related to the remit of the Committee, rather than its composition, which is frankly an irrelevance compared with the problems of the moving feast of its remit.
	The remit has been set so vaguely that it can incorporate anything and everything. We will face the economic consequences when the partially state-owned banks are hit in the same way. These issues are entirely out of our control—indeed, they are entirely out of British control. The American authorities are two years ahead of the British authorities, and have taken a lead, so they will dictate the time scale for what comes next. Whether the considerations are legal or political—there are elections coming up, so there may well be more of a political imperative to be seen to be doing things—they will have grave consequences for these financial institutions and the British taxpayer.
	That is why although it may well come up with worthy and credible recommendations, the investigation cannot match the task that it has been set. Because of the course of events and the changes that will happen, arbitrary time limits are, by definition, self-defeating. There is another problem that goes alongside that, and it concerns the other options available to look at those matters. I am pleased that the Leader of the House appears to have given a commitment, and I urge him to clarify it, that no staffing resource will be removed from the Treasury Committee in that period of time. If that is the case, that is a significant step forward. If the Treasury Committee were mothballed at precisely this time, the ability of the House to respond to fast-moving events would worsen significantly.
	The Treasury Committee has a heavy workload. Today, Commissioner Barnier was supposed to appear before the Committee in relation to the 17 EU directives and draft directives relating to financial services on the books at the moment. It is essential that this House properly scrutinises and takes a view on what happens with those directives, but that has not been happening—it is a key role that the Treasury Committee needs to fulfil.

Kevan Jones: Does my hon. Friend agree that there may well be some dispute about what the Treasury Committee should look at and what this new Commission should look at—if, for example, another scandal or something like it emerged in the next few weeks?

John Mann: My hon. Friend makes the point that I have been stressing—that we do not know and cannot predict them, but we know that there will be a lot more scandals emerging, as we are only seeing the tip of the iceberg at present. [Interruption.] I appreciate that this is not good listening for those hon. Members trying to work out how to respond to this, but if this House is to set up arbitrary ad hoc committees at random every time there is a problem, it will potentially undermine itself. Which Select Committee will be next to give away some of its powers to an ad hoc committee? Is this the appropriate way to determine such matters?
	If some of the powers set out in the motion were reinforced not just in respect of the Treasury Select Committee but of other Select Committees, that would reinforce the scrutiny of this House over what goes on both in government and in the country, so there are some good proposals here. The good proposals, however, are bespoke to this particular Commission—for example, the ability to call in a QC and the ability to take evidence on oath. If they are good enough for this new
	Commission, they should be made available to any Select Committee looking at any issue. The House is ducking this problem.

Peter Bone: I think the hon. Gentleman is making some powerful and important points. Does he share my surprise that the Treasury Select Committee was not given this role? He is absolutely right: these powers should be given to all Select Committees to make Parliament more powerful.

John Mann: I take the hon. Gentleman’s point and I agree with him, but I do not intend to go through all the previous debate on this issue—interesting though it would be to do so—because I am sticking to the detail of what is in front of us, however badly it is worded. There is, however, clearly a case for saying that if the Treasury Committee had been allowed to carry on this work, it could have done so as effectively as this Joint Committee. I am sure that the five Members from the House of Lords who are as yet unknown and unnamed will bring great wisdom to this Joint Committee, but if the House of Lords wants to look into matters, it can look into them. This is the elected Chamber, and for this elected Chamber to hand over some of these powers of scrutiny to an unelected Chamber seems a retrograde step, which will come back to haunt us in future.
	Once a precedent has been established and it suits the Government, it is likely to happen again—and this was a Government initiative. I am rather surprised that the Opposition Front-Bench team, perhaps looking forward to being in government themselves, have been seduced into accepting this way of undermining the historic, developed and improving role of this House to scrutinise. That, I think, is partly what is at stake here, if this becomes the way of doing business in this House.
	I do not see how a Select Committee, denuded of half its members, can in any way work as effectively as a Select Committee operating with all its members. That is the reality of what will happen, and we need to be aware of the unintended consequences that might come from a potential eurozone crisis and other problems emanating from Europe that conflict across the work of this Joint Committee—and are wrongly not referred to within it—because proposals from Brussels are, rightly or wrongly, a fundamental part of the equation, affecting decisions made by this House and by the banking industry in this country and across the world. That aspect has been ducked by the creation of the Commission, which will create unhealthy confusion in the debate.
	What should have happened? The remit given to the investigation, which should have been carried out by the Treasury Committee, should have been far broader—[ Interruption. ] An hon. Gentleman says “Boring” from a sedentary position, but this is not boring. For example, seven investment banks colluded to rig the price of the Kraft takeover of Cadbury’s. That is the real scandal that underpins the profits in investment banking. In some areas, there is ferocious competition, but in the vast majority of investment banking, there is no competition whatever. That is the scandal that created the culture that led to the LIBOR rigging. An investment bank called in by a company to advise on a sale or takeover has so much knowledge of the workings of the company
	that it has the ability to manipulate the market to determine how things will go. That is the fundamental weakness in the system of investment banking. The implications for British manufacturing and manufacturing elsewhere in the world—

Mr Speaker: Order. I have noted the hon. Gentleman’s references to investment banking, but I fear—very considerably—that he is now going to proceed to discuss the state of British manufacturing and any relationship between the banking and manufacturing sectors. He is gyrating between referring to the terms of reference of the Commission and matters of composition, and then talking about matters that are quite outwith the terms of the motion, which ought to afford him adequate scope. I feel cautiously hopeful that he may be nearer to the end of his remarks than to the beginning.

John Mann: I have so far got to paragraph (1)(b) of the motion, which I shall quote, so that you are assured, Mr Speaker, that my remarks are directly pertinent. Paragraph (1)(b) refers to
	“lessons to be learned about corporate governance, transparency and conflicts of interest, and their implications for regulation and for Government policy”.
	That is precisely what I was talking about in relation to how investment banks operate. The lack of transparency, conflicts of interests and the narrow remit—

Mr Speaker: Order. I am sure the hon. Gentleman is public spirited and trying to be helpful, but he should not misunderstand the terms of the motion. The paragraph to which he refers underlines the importance of the inquiry in learning those lessons. It is not necessary or feasible for the House to do so tonight. It would be a triumph of optimism over reality for him to suppose that the House would do so courtesy of his speech, no matter how compelling it is.

John Mann: Thank you for that guidance, Mr Speaker. I am merely outlining my objections to the lack of breadth in the remit given to the Commission.
	My final questions on paragraph (1)(b)—[Hon. Members: “Hooray!”] I am surprised hon. Members are so keen to stay and hear the debate, given some of their sedentary comments. It would be helpful if the Leader of the House confirmed unambiguously that the principles behind the setting up of the Commission will in no way—practically and in reality—undermine the ability of the Treasury Committee to meet as often as it has over the past year to discuss subjects that it chooses to investigate. It would help if he confirmed that it can call the witnesses it chooses and that it will have the access to the staffing resource and expertise that it currently has. If he can give those assurances, I will not seek to divide the House on the motion. I look forward to hearing from him.

John McDonnell: I want to make a brief point about paragraph (1)(a), which sets out the terms of reference. Some months ago there were reports, which I raised with the Prime Minister, about the Bank of England’s intervention with at least one bank, and perhaps more, about the manipulation of the quantitative easing auctions. I would welcome an
	assurance that paragraph (1)(a) will cover that issue as well, rather than just the LIBOR issue, because it is a matter of concern if a single bank or a number of banks sought to profiteer from the quantitative easing that was put in place by the Government to rescue the banks. Indeed, it seems extraordinary that the banks would seek to profiteer from the taxpayers’ money that was used to intervene and save them from the crisis that they had brought about. I would welcome an assurance from the Chair of the inquiry that that matter, as well as LIBOR, will be looked into when we consider the issue of transparency and the ability of the banks to manipulate the system overall.

Mark Durkan: I have quite fundamental reservations about the motion before us this evening, because, a bit like the hon. Member for Bassetlaw (John Mann), I have serious concerns about the implications for the work of the Treasury Committee. The way in which we are moving to set up the Commission, with a selection of members of the Treasury Committee—almost a Treasury Committee A team—being assigned to the Commission, will obviously have an impact on the Committee’s working capacity at a key time.
	We heard from the Chancellor in the Chamber two weeks ago that he was appointing Martin Wheatley, the incoming chief executive of the Financial Services Authority, to conduct a review that would report within six weeks. That review was going to make recommendations that could feed into reconsideration of the Financial Services Bill. I would have thought that the outcome of the Wheatley review would be the subject of serious consideration by the Treasury Committee. I also wonder how the House would consider the implications of that urgent review, which the Chancellor has instigated, under Martin Wheatley. Will the Financial Services Bill Committee be reconstituted or will we just receive scrambled amendments? There will be confusion, because the Wheatley review is meant to come up with recommendations for legislative change—through the Financial Services Bill first, but possibly also through the banking reform Bill, which the Government have told us is due in the new year. Surely the journey to the banking reform Bill should involve serious consideration and pre-legislative scrutiny by the Treasury Committee, and perhaps others too.
	I am not sure how the Treasury Committee can perform its usual role of giving such key legislative consideration if so many of its members and its Chairman are absorbed in the inquiry that this motion establishes—an inquiry that will be intensive and could even turn out to be extensive, in terms of the issues it gets into. We as a House are asking the Commission to surf a very dense, murky and smelly swamp in short order and come up with clear findings and recommendations. We are assigning it quite an inordinate task, which not only will be hard to achieve in itself, but will end up damaging the work of the Treasury Committee.
	As someone who sat on the Financial Services Bill Committee, I was conscious of the fact that we had many members of the Treasury Committee serving on that Committee. I was also struck, however, by the fact that they resiled from positions that they had agreed to, as members of the Treasury Select Committee, in their very good report into aspects of the Financial Services
	Bill. It was quite common for the hon. Member for Nottingham East (Chris Leslie) to make points in that Bill Committee in which he quoted extensively from the Treasury Select Committee report, only for members of the Select Committee to disown the report or distance themselves from it. I was almost expecting them to say that they were not inextricably linked to their membership of the Select Committee in that particular capacity. That experience gives me concern about splitting the attention and capacity of the Treasury Select Committee in this way, and I worry that this might be a well-motivated misadventure in regard to its implications for the work of the Committee.
	I hope that the Leader of the House will be able to clarify the Government’s hopes and intentions in relation to the timing of the Financial Services Bill and any amendments that they believe should be made to it in the light of the LIBOR scandal, given the Chancellor’s statement two weeks ago, and in relation to the banking reform Bill. There appear to be potentially overlapping and intersecting reviews going on, and if we in this Chamber are mandating them, we need to take responsibility for the possible confusion that could be caused to others and to ourselves.
	I do not believe that these arrangements will be enough to deal with the scale of the problem or the questions that it raises not only about banking but about the competence and due diligence of this Parliament. Are we as parliamentarians up to the task of properly scrutinising legislation and introducing regulatory changes? Is it enough for us to devolve the task to a group of people hand-picked from the Treasury Select Committee by the Whips and expect them to come up with all the answers while we take responsibility only for receiving them? I do not think that that is good enough.
	I did not vote for a parliamentary inquiry device when we voted on the matter the week before last, but I accept that this is the chosen outcome. I have serious reservations about the way in which the terms of reference for the Commission have been laid out here, and about the possibility of its composition weakening the Treasury Select Committee at a key time when two Bills are due to come back to us in the autumn, along with another Bill in the new year. I am also worried about the Committee’s ability to deal with other unfolding revelations that might emerge not only from the LIBOR scandal but from issues relating to quantitative easing, to which the hon. Member for Hayes and Harlington (John McDonnell) referred, and to deal with the outflow from the machinations in the eurozone.
	There is a lot of work for the Treasury Select Committee to concentrate on, and I am not sure that it will be assisted by the creation of this device. If the Committee is content with the arrangement, I will have to accept its opinion. However, that does not absolve us in this Chamber from our legislative responsibility in respect of those two Bills, which the Chancellor has told us could be directly relevant and whose scope and reach will need to be adjusted to take account of the LIBOR scandal and possibly other scandals as well.
	I have profound reservations, but I wish those who are undertaking the inquiry well. They have a difficult task ahead of them, and I do not know how they are meant to perform it if, as the motion suggests, they will sometimes be expected to work as sub-Committees of
	one. That would create the bizarre scenario of a sub-Committee of one relying on the hired specialist advisers and other agents who will be licensed by this motion. That would create some fairly peculiar scenarios that Parliament might find hard to stand over. Members of the Commission might also find it hard comfortably to take ownership of all the undertakings of the Commission, given the odd construct that is provided for in the motion. I accept that this is a scramble in particular circumstances, and that time is pressing. However, I am not sure that it has been a good scramble. I think that there should have been better thought and more consideration, and I think that many of the people who are comfortable with this device now may end up regretting their decision.

Peter Bone: It is a great pleasure to follow the hon. Member for Foyle (Mark Durkan), who is always worth listening to, but I have to say that on this occasion I disagreed with many of the points he made. I think that this is a chance for Parliament to assert itself. I think that it is a new adventure for Parliament. If the Commission is successful—if it produces a report that is unanimous and not split along party lines, and if it uses all the additional powers that it is being given—that will be a great step forward, and the arrangement may be repeated in the future. I take a much more optimistic view than the hon. Gentleman. The fact that so many Members are in the Chamber late at night shows how interested they are in the issue.
	I have just two questions to put to the Leader of the House. One concerns paragraph (3), which names the members of the Commission. I am not sure how they were selected. I would have found it understandable for all the members of the Treasury Committee to be members of the Commission, because they were elected to their positions, but how did these particular names come to be here? Certain other Members’ names are not here although perhaps they should be. I am surprised, for instance, that a certain lady Member’s name is not included. Was it purple smoke, or was it, as I fear, the usual channels? Perhaps the Leader of the House could clear that up.
	I welcome the Leader of the House’s announcement of an open-ended commitment from the Treasury to provide money for the counsel to the Commission. Does he hope, like me, that the counsel will act rather like a congressional committee and will grill the witnesses, and that members of the Commission will then be able to ask questions? I think that if we set up that sort of arrangement, we shall be moving Parliament forward.

Kevan Jones: Let me begin by reiterating the point made by my hon. Friend the Member for Wallasey (Ms Eagle), who said that we had voted for a judge-led inquiry. We are setting an onerous task for the Commission. I think it was my hon. Friend the Member for Bassetlaw (John Mann) who said that it would be looked at very closely by members of the public, who now have very little faith in our banking system, whether because of national scandals or because of their dealings with their own local banks.
	The terms of reference are set out clearly in paragraph (1)(a), which mentions the
	“professional standards and culture of the UK banking sector”.
	I should be interested to know how “culture” is defined in the context of banking. Does it refer only to banks, or to building societies as well? We should bear it in mind that the banking industry consists of not only high-street chains but, for instance, mutual societies. Will they be included in the Commission’s investigation?
	LIBOR was the catalyst for the establishment of the Commission. Paragraph (1)(b) refers to
	“lessons to be learned about corporate governance, transparency and conflicts of interest, and their implications for regulation and for Government policy”.
	You pulled up my hon. Friend the Member for Bassetlaw on the issue of corporate governance, Mr Speaker, and I accept your ruling. However, many of the matters that the Commission will consider will not relate purely to banking. As my hon. Friend said, they will relate to lending and takeover bids for companies. Will the Commission look into the culture of, for example, the Kraft takeover, which my hon. Friend mentioned? If it restricts its consideration to the banking sector, will not the inquiry be of limited use, not just in view of the vehicles involved in such events as the Kraft takeover but—I hasten to add—in view of some of the things that have been going on in local government? I have raised the issue of the refinancing of Newcastle airport, for example, which was a huge scandal in the north-east two years ago. That was driven by the idea that we could get a better deal for the local council tax payer by refinancing. In fact, it got them a worse deal. Will the Committee look at such situations?
	Turning to transparency and governance, Government Members had strong opinions about private finance initiative deals when they were in opposition, and they still hold to those views now. Will such financing arrangements fall within the remit of paragraph (1)(a) and (b), as they are clearly part of a new culture that has emerged, and they are a new mechanism for funding Government policy? Paragraph (1)(b) refers to
	“implications for regulation and for Government policy.”
	Would today’s announcements on the investment in the railways fall within the remit? That is being financed in part through Network Rail, which is a completely separate organisation and is off the Government balance sheet. The Committee’s remit could lead to such areas being investigated. There are some wider implications here, therefore, and it will be interesting to see if the Committee resists going down certain paths. If we do not have a full inquiry that looks at all these areas, the public may well think we are just concentrating on a small part of the banking and finance industry, when there are many other concerns that directly affect them, too.
	I have great respect for the Chair of the Treasury Committee, the hon. Member for Chichester (Mr Tyrie), who will chair this Commission, but the hon. Member for Wellingborough (Mr Bone) mentioned the absence of any women on the nomination list from this House. Are we saying that there are no able hon. Ladies from either side of the House who could sit on this Committee? We have in the past tried to ensure that all Committees in this House include women Members. This is an omission, therefore. It may be possible that all the
	members from the House of Lords will be men, too. We would therefore have a Committee made up entirely of males, which would be very wrong. It would be right to include a certain—female—member of the Treasury Committee on the Commission. Obviously that hon. Lady did not fit the loyalty criteria set by the usual channels, however. Her inclusion could have been useful, especially in light of her previous life in the banking industry.
	We are going to agree this motion tonight when we do not know who the Lords members of the Committee will be. I agree with the position of my hon. Friend the Member for Bassetlaw: this is a slippery slope as we are agreeing to have a Joint Committee to scrutinise and make recommendations with some members who have never been elected—and some of whom are, perhaps, unelectable.
	Another interesting question is what the powers of this Committee will be. Paragraph (7)(a) states that it will have the power to
	“send for persons, papers and records”.
	What will happen if an individual says, “No”? Will the Committee have the full powers of Parliament to enforce its will in this regard?
	It is also stated that witnesses will be under oath, and also that the Committee will be able to appoint special advisers. That is very important in respect of the expertise it will bring to the Committee. There is a question to be asked about a possible declaration of interests by those individuals, however. Many of the people who have expertise in this field will have had direct involvement in the culture that this Committee will be examining. So what will be the restrictions on the appointment of those advisers in respect of either their past lives or any future involvement they may have? That needs to be spelt out from the beginning. We need to make sure that they have not got their fingers in any of the pies that this Commission is investigating.
	I do not wish to cast aspersions on any members of the Commission from this House, but we do not know who its members will be from the other House. How are we to define declarations of interest? Are these interests that those individuals hold now or in previous lives? If they are commercial interests, that will raise questions about the impartiality of those individuals, and anything that does that will damage the Commission from the outset.
	Paragraph (7)(d) has already been mentioned. It states:
	“to invite specialist advisers (including Counsel appointed as specialist advisers) to examine witnesses”.
	I am not sure what that means. The normal procedure that Select Committees follow is that the members ask the questions, and questions and briefing notes are clearly written in advance by advisers. This arrangement, however, is very different. This is about having special advisers being able to cross-examine witnesses. So what is the status of those individuals? As the hon. Member for Wellingborough has said, that is a huge change from the way in which Select Committees have operated in this House. When I served on the Select Committee on Defence we had some very able advisers, but the idea that they would cross-examine witnesses is a strange one. We need clarification on that matter.
	What about specialist advisers and conflicts of interest? If they are going to be counsel, we need to ask whether they have ever acted for banks or financial institutions.
	Would that debar them from being appointed as an adviser to the Commission? It is important that we have those things laid out clearly right at the beginning. I do not think it is right to leave them up to the Committee or the Chair to determine.
	[Interruption.]
	Government Members may well think that this is frivolous, but to many of our constituents it will be very important, in terms not only of how their money is looked after, but of trying to get credibility back into a sector that is vital to this country’s economy. This is very important in terms of making sure we get it right and of the reputation of the Members of this House who are going to be serving on the Commission.
	The other thing I wish to discuss is how the Commission is going to be financed. Paragraph (13) says that
	“the costs of the Commission shall be assessed by the House of Commons Commission from time to time and shall be paid by Her Majesty’s Government for the credit of the House of Commons (Administration) Estimate.”
	We all know that, if someone wants to control the activities of a committee or any organisation, they can starve it of money. Are we saying that this Commission has a blank cheque? Unless it has, the Government will be able to starve it of money and limit the scope of its activities.
	Paragraph (7)(e) states that the Commission can
	“adjourn from place to place”.
	If a lot of foreign travel is involved, as may well be the case, that will create an expense. Who makes the determination on that in terms of the work the Commission does? Will the Treasury at some point try to limit it by saying, “I am sorry, but you have spent too much and so you cannot undertake that foreign travel or employ that expert witness to interrogate and produce the report”?
	There are a lot of—[ Interruption. ] The hon. Member for Ealing Central and Acton (Angie Bray) is chuntering from a sedentary position, but she has only just come into the Chamber. I know that she did not have a very good week last week, but I wish her all the best for the future.
	The financing of the Commission will be very important, so we need some assurance that we will not have interference by Government in the Commission’s work by stealth—that is, by starving it of the resources it needs.

Peter Bone: The hon. Gentleman is making serious points about parliamentary scrutiny, and it is great that so many Government Members are present to support him. Does he welcome this new initiative? If there is unlimited funding, if there can be counsel and if the Commission can cross-examine in the same way as congressional committees, is that not a good thing?

Kevan Jones: It is—[Hon. Members: “Ah!] Hon. Members have not heard what I am going to say yet. I agree with the hon. Gentleman, but we have seen this problem with Select Committees, whose travel was limited in the previous Parliament, hampering their work. As the Commission will be subject to the Government’s decision on whether they can fund it or not, that is a very important point. If the situation will be that suggested by the hon. Gentleman, we should have the same arrangements for Select Committees. That would ensure that Select Committees could not only employ the proper advisers—and perhaps more of them—and see expert witnesses but undertake the detailed travel that is sometimes required.
	My other concern is paragraph (12)(b), which concerns the setting up of sub-committees. There is no detail about how sub-committees will be set up or about their composition. Paragraph (12)(b) states that a sub-committee will have a quorum of one, but how big will the committees be?
	I am very uncomfortable with the idea of a sub-committee of one person making decisions or taking evidence. It should include at least one person from each House: a Member from this House and one from the other House. Likewise, on the question of political balance, it could include a Government Member and an Opposition Member. If we are going to have sub-committees, surely it would be right to increase the quorum to at least two, one from each House, and, potentially, to try to get political balance.
	There are many provisions in the motion that prompt many questions. The hon. Member for Wellingborough made a very good point, in that it sets a lot of precedents and, I hope, sets a way forward that Select Committees can follow to draw down more resources and increase their powers.
	I also want to raise the issue of the Commission’s reports. The motion states that it will
	“report from time to time.”
	Who will decide? If the Commission as a whole decides to produce interim reports or short reports throughout its life, some of them will be very market sensitive. Will not the Commission have to be very cautious in what it releases? I am sure that many finance houses, banks and other parts of the financial sector will be looking very closely at what the Commission recommends, and it could affect the share prices of those organisations. There is no guidance in the motion about how those reports should be produced, according to what time scale and for what reasons.
	The other question that was mentioned earlier is whether we are happy now that we have basically set up a new type of Select Committee. Personally, I am not. I think that this inquiry would have been far better done by the Treasury Committee. Obviously, those on the Front Bench from my own party argued strongly for a judicial-led inquiry, which was the right approach to get confidence in the banking system. In the absence of such an inquiry, the Treasury Committee would perhaps have been a better vehicle. I worry about the precedent that this sets and whether it will allow the Government of the day to dictate to Select Committees or hybrid Committees. That goes to the heart of the independence of those Committees and their accountability to Parliament. The Commission will have a huge job to do and I wish it well in its deliberations, but we should undertake a serious examination of the new system and the precedent that that sets for our Select Committees.
	Question put and agreed to.
	Ordered,
	(1) That a Committee of this House be established, to be called the Parliamentary Commission on Banking Standards, to consider and report on—
	(a) professional standards and culture of the UK banking sector, taking account of regulatory and competition investigations into the LIBOR ratesetting process;
	(b) lessons to be learned about corporate governance, transparency and conflicts of interest, and their implications for regulation and for Government policy;
	and to make recommendations for legislative and other action.
	(2) That Mr Andrew Tyrie be Chair of the Commission.
	(3) That Mark Garnier, Mr Andrew Love, Mr Pat McFadden and John Thurso be members of the Commission.
	(4) That the Commission have leave to join with any committee appointed by the Lords to consider the said matters.
	(5) That the Commission may hold meetings under the provisions of paragraph (4) of this order at any time after the Lords has agreed to appoint a committee.
	(6) That the Commission shall, except as provided for in this order, follow the procedure of a select committee of this House.
	(7) That the Commission shall have power—
	(a) to send for persons, papers and records;
	(b) to examine witnesses on oath;
	(c) to appoint specialist advisers;
	(d) to invite specialist advisers (including Counsel appointed as specialist advisers) to examine witnesses;
	(e) to adjourn from place to place;
	(f) to sit notwithstanding any adjournment of the House; and
	(g) to report from time to time.
	(8) That the Commission shall have power to appoint sub-committees to consider matters specified by the Commission within the terms of this order and a subcommittee shall have—
	(a) the powers in paragraph (7)(a), (b), (e) and (f); and
	(b) the power to invite specialist advisers appointed by the Commission (including Counsel appointed as specialist advisers) to examine witnesses;
	and the quorum of a sub-committee shall, subject to paragraph (12)(b), be one member of this House.
	(9) That the Chair may report to the House an order, resolution or Special Report as an order, resolution or Special Report of the Commission which has not been agreed at a meeting of the Commission if he is satisfied that he has consulted all members of the Commission about the terms of the order, resolution or Special Report and that it represents a decision of the majority of the Commission.
	(10) That the quorum of the Commission shall be two members of this House.
	(11) That, whenever this House shall stand adjourned other than to the next day, any report, Special Report, order or resolution agreed to by, or evidence taken or received by, the Commission, including any under paragraph (9) of this order, may be published or printed under the authority of this House, shall be deemed to have been reported and shall be reported when this House next sits.
	(12) That, when the Commission operates under the provisions of paragraph (4) of this order, the following provisions shall apply—
	(a) the quorum of the Commission shall be two members of this House and two members of the House of Lords;
	(b) the quorum of any sub-committee shall be one member from either House;
	and
	(c) the power of the Chair to report under paragraph (9) may also be exercised with the Chair’s agreement by a member of the Commission who is a member of the House of Lords.
	(13) That the costs of the Commission shall be assessed by the House of Commons Commission from time to time and shall be paid by Her Majesty’s Government for the credit of the House of Commons (Administration) Estimate.
	(14) That the Commission shall report on legislative action no later than 18 December 2012 and on other matters as soon as possible thereafter.
	(15) That a message be sent to the House of Lords to desire their concurrence.—(Sir George Young.)

Business Without Debate
	 — 
	arrangement of public business

Ordered,
	That the following changes to Standing Order No. 14 (Arrangement of public business) be made, with effect from Monday 15 October 2012:
	– in line 19, leave out ‘or Tuesday, four o’clock on’ and insert ‘, four o’clock on Tuesday or’;
	– in line 20, leave out ‘three’ and insert ‘two’; and
	– in line 29, leave out ‘three’ and insert ‘two’.—(Greg Hands.)

sittings in westminster hall (e-petitions)

Motion made,
	(1) That the following changes be made to Standing Order No. 10 (Sittings in Westminster Hall) until the end of the next session of Parliament:
	(a) in line 3, at the end, add the following new sub-paragraph—
	‘(za) on Mondays beginning at half-past four o’clock and continuing for up to three hours, if the Backbench Business Committee has reported its determination that a sitting in Westminster Hall to consider an epetition or e-petitions should take place on that day;’.
	(b) in line 28, at the end, add the following new paragraph—
	‘(3B) (a) The business taken at a Monday sitting in Westminster Hall shall be the e-petition or e-petitions which the Backbench Business Committee has determined should be debated, and each such e-petition shall be debated on the motion, That this House has considered the e-petition from [petitioners] relating to [subject of petition].
	(b) Paragraph (10) of this Order shall not apply to proceedings under sub-paragraph (b) of this paragraph; no dilatory motion may be made in relation to proceedings under that sub-paragraph except by a Minister of the Crown; and the question on any such dilatory motion shall be put forthwith.’
	(2) That the following new paragraph be added to Standing Order No. 14 (Arrangement of public business), in line 50, at the end:
	‘(3AA) In addition to those days allotted under paragraph (3A) of this order, the Backbench Business Committee may determine that a sitting in Westminster Hall may be held on a Monday in accordance with paragraph (3) (za) of Standing Order No. 10 to consider e-petitions.’
	(3) That Standing Order No. 152J (Backbench Business Committee) be amended by leaving out from ‘with’ in line 39 to ‘of’ in line 40 and inserting ‘paragraphs (3A) and (3B)’.—(Greg Hands.)

Hon. Members: Object.

business, innovation and skills

Ordered,
	That Mr David Ward be discharged from the Business, Innovation and Skills Committee and Mike Crockart be added.—(Mr Alan Campbell, on behalf of the Committee of Selection.)

PETITIONS

Policing (Winsor Reforms)

Jonathan Reynolds: I am pleased to have chosen this evening to present this petition from residents of my constituency and the neighbouring areas, prompted by a meeting that I held with local police officers.
	The petition states:
	The Petition of residents of Stalybridge and Hyde and the Greater Manchester area,
	Declares that the proposals made in the second part of the Winsor Review will have a devastating effect on the morale of frontline officers, and risk a detrimental effect on the quality of service the Police provide to the public.
	The Petitioners therefore request that the House of Commons urges the Home Secretary to reject the recommendations contained within the Winsor Review.
	And the Petitioners remain, etc.
	[P001103]

Rushden Ambulance Station (Northamptonshire)

Peter Bone: I have a petition with 3,673 names on it, organised by a very nice lady in my constituency called Mrs Dorothy Maxwell. The problem that we have in Rushden is that the East Midlands Ambulance Service is rather poor and is getting worse. The way that the ambulance service has decided to solve that problem is to close the ambulance station. That, as might be expected, has not been universally welcomed.
	The petition reads:
	The Humble Petition of residents of Rushden, Higham Ferrers, East Northamptonshire, and surrounding areas
	Sheweth,
	That the proposed closure of Rushden Ambulance station will detrimentally affect the 97,500 people that live in the local area, reducing response time and providing an inferior service.
	Wherefore your Petitioners pray that your Honourable House requests the Secretary of State for Health to urge the Northamptonshire County Council, the District Council of East Northamptonshire and East Midlands Ambulance Service to work together to find a solution that will allow the Rushden Ambulance station to remain open.
	And your Petitioners, as in duty bound, will ever pray, etc.
	[P001110]

Independent Pharmacy Provision (Brierley Hill, Dudley)

Chris Kelly: It is my pleasure to present this petition when the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), is on the Front Bench. I was recently contacted by Vijaykumar Lad of Kingswinford, the proprietor of Ian McArdle’s, the independent pharmacy in Brierley Hill, which has been trading for more than 40 years. Mr Lad is concerned about the number of applications for 100-hour pharmacies in Brierley Hill, which he and his customers feel will threaten the survival of existing pharmacy provision there.
	Upon visiting McArdle’s pharmacy to meet Mr Lad and several of his customers, I was presented with a petition signed by more than 1,000 residents who wished to see McArdle’s of Brierley Hill saved. I therefore present this petition to the House.
	The petition states:
	The Petition of users of McArdles Pharmacy, Brierley Hill and others,
	Declares that the Petitioners are concerned about proposals to allow three further pharmacies to open in Brierley Hill town centre that will each trade for more than 100 hours per week, as the Petitioners believe that adequate pharmaceutical services are
	already provided by the network of three well established pharmacies and that these unnecessary and undesirable new pharmacies will jeopardise the existing businesses that have provided personal care to customers for more than 40 years. The Petitioners therefore request that the House of Commons urges the Government to ask Dudley Primary Care Trust to reject any application for the opening of further pharmacies in Brierley Hill town centre.
	And the Petitioners remain, etc.
	[P001111]

NHS (RATIONING OF CARE)

Motion made, and Question proposed, That this House do now adjourn.—(Greg Hands.)

Mary Glindon: This issue has already been raised today in the debate on a motion in the main business of the House, but I believe that the growing concern about rationing in the NHS justifies further debate tonight. For almost as long as the NHS has existed, rationing has been a matter of concern. Resources are finite, but in the past two years rationing has reached an unprecedented level; more than 125 previously free treatments have now been restricted or even stopped altogether, and they cover the full health care spectrum, from the cosmetic to the essential and all stages in between.
	These findings were revealed in a survey, carried out by Labour’s shadow health team, of all NHS primary care trusts and shadow clinical commissioning groups in England. It is important to state the relevance of Labour’s new NHS check, which I will refer to in my speech, because as well as conducting surveys it gathers together the views of those working in the health service and takes into account the views of those receiving the service and their families. The submissions are considered alongside evidence from freedom of information requests to produce an accurate and relevant monthly report, such as the one on rationing.
	Labour’s findings are backed by members of the British Medical Association who warn that creeping NHS rationing is making patients suffer unnecessarily, with people who need hip and knee replacements having to wait longer for operations while suffering in pain. GPs believe that the rationing is the result of the drive to make savings in the NHS of up to £20 billion by 2015. That is further borne out by the results of a poll conducted by the BBC in March, which found that more than four out of five GPs expect the rationing of NHS care to increase in response to financial pressure.
	The concerns of the medical profession are echoed by other professions in the health service. Ahead of this debate I was contacted by the Chartered Society of Physiotherapy, which is very concerned about the rationing of NHS physiotherapy services and has a number of examples of patient care and outcomes suffering as a result. The CSP opposed the Health and Social Care Bill and the Government’s reforms to the NHS because of concerns about the negative impact on patient care resulting from rationing and the fragmentation of services. It is particularly concerned about the “any qualified provider” model and has found that patient choice is being adversely affected by the clear rationing of treatment and access in some of the “any qualified provider” service specifications, which it has systematically reviewed. For example, in Nottinghamshire the amount of treatment prescribed is limited without regard to patient need. In other areas, no re-referrals are allowed within a six or 12-month period, also regardless of patient need. This rationing is likely to lead to increased orthopaedic referrals and unnecessary surgical interventions.
	The CSP has further concerns about the impact of the “any qualified provider” model, including a reduction in patient choice and the quality of care, the loss of clinically and cost-effective innovations such as self-referral
	to physiotherapy, the negative impact on the physiotherapy profession and the risk of conflicts of interest among private providers. Those are all legitimate concerns from a respected professional body, so I hope that the Minister will address them specifically with the society.
	The Minister has denied the relevance of the shadow Health team’s extensive survey, the NHS check, but perhaps he should reconsider his opinion of it, because the survey’s findings mirror those of GP magazine, which gathered evidence under the Freedom of Information Act, showing that 90% of primary care trusts were imposing restrictions. The magazine received responses from two thirds of England’s 151 trusts on the procedures that they considered to be non-urgent. The most common restriction was on tonsillectomies, but there was rationing in other areas, too.

Jamie Reed: Will my hon. Friend give way?

Mary Glindon: I will.

Nigel Evans: Order. You can make an intervention, Mr Reed, but not from the Opposition Front Bench. If you step up to another Bench, you may intervene from there.

Jamie Reed: Thank you, Mr Deputy Speaker. I trust that this is in order.
	Will my hon. Friend join me in asking the Minister, who has indicated that he will not take interventions from me this evening, whether he will undertake a nationwide investigation into the clear rationing that is occurring in the NHS, and whether the Government will publish a list of procedures in which the eligibility criteria for treatment are now being changed? Will she join me also in asking the Government to act where various NHS organisations are breaching NICE guidelines on treatments offered to patients?

Mary Glindon: I certainly will, and my hon. Friend may find that at the end of my speech I reiterate some of what he has said.
	There is rationing in other areas, too, with 66% of trusts limiting cataract surgery and more than half rationing weight-loss surgery and hip and knee operations. Dr Richard Vautrey of the British Medical Association describes the situation as a “cost-saving exercise”, saying quite rightly:
	“Patients fully understand the NHS doesn’t have unlimited resources...but they don’t understand, or believe it’s fair, when services are provided in one area but not another.”
	The Labour party’s survey provides evidence of random rationing throughout the NHS, and of an accelerating postcode lottery. A number of rationed or decommissioned treatments are common across several PCTs and clinical commissioning groups, while some are specific to individual PCTs and CCGs. That demonstrates the wide variation throughout the country.
	The survey found that rationing of treatment varies from capping, as in NHS South West Essex and NHS South East Essex, where a cap has been placed on the community diabetes service, to restricting treatment based on age or clinical need, as in NHS Warwickshire,
	where new criteria require that a patient must complain of intense or severe symptomatology and have a BMI of less than 40 to be listed for a knee replacement.
	Evidence also showed, alarmingly, that PCTs and CCGs are diverging from the NICE guidelines, as in NHS Bassetlaw, where needle fasciotomy for Dupuytren's contracture is considered only if the patient is aged over 45 and has a loss of extension in one or more joints exceeding 25°, or if the patient is under 45 years old and has a greater than 10° loss of extension in two or more joints. However, the NICE guidelines do not refer to degree of loss of extension or any specific age criteria, other than to say that the procedure would be more appropriate in older people.
	Equally alarming are the findings that show that patients now have to pay for treatments that had been free. In a surgery in Yorkshire, patients needing treatments for cysts, skin lesions and in-growing toenails were told that they were no longer available on the NHS. But the practice had established a private company to offer those minor operations at a cost: £56.30 for the removal of a small cyst; £126 for larger cysts; £146.95 for the removal of an in-growing toenail; and £243 for the removal of a non-cancerous mole.
	In response to the GP magazine report, the Minister said:
	“It is quite unacceptable if this is going on in all those cases. As you’ll appreciate, it is a complex issue. But the defining point is that people should be treated on clinical need, and not financial considerations.”
	The findings of the BMA, the concerns of other health professionals, such as the Chartered Society of Physiotherapy, and the results of Labour’s in-depth survey all point to the fact that, because of increasing rationing, people are being treated on the basis not of clinical need, but of financial considerations.
	Will the Minister respond positively to Labour’s call for an immediate review of rationing in the NHS and act immediately on the new evidence showing treatment restriction on cost alone? How will he ensure that national guidelines can be implemented? Will he take action, pending the outcome of the review, to reverse immediately rationing decisions that leave patients in severe pain, restrict mobility, limit their ability to live independently or have a major psychological impact? Will the Government initiate a public debate on whether all other treatments should be provided by the NHS, rather than allowing them to be restricted in a random fashion?

Jamie Reed: I am grateful to my hon. Friend for letting me intervene once more. Will she also join me in asking the Minister to publish whatever assessment must have been made into the claims forthcoming from the freedom of information requests shown to the Department of Health? Will she join me in asking the Government to publish that assessment of those claims?

Mary Glindon: I certainly join my hon. Friend in asking the Government to publish the assessment.
	In denying the findings of Labour’s survey of rationing and the supporting evidence from the BMA and other professional bodies working in the NHS, the Government are denying the people of this country the full NHS service that they deserve and have contributed towards.

Julie Hilling: I am listening with great interest to my hon. Friend’s speech. Does the decrease in care free at the point of delivery match the increase in the care that is then paid for by patients? Are the hospitals now offering all that care to people as long as they pay for it?

Mary Glindon: I thank my hon. Friend for that intervention. As I have outlined, one of the terrible things is that people have to pay. However, in some instances, treatment is simply not available any longer.
	Finally, I should say that my party accepts that there has to be a debate on some treatments that are of borderline value, but that debate should be part of a national review. I hope the Minister will respond positively to the request for an immediate review, allow a full and positive debate to begin, and arbitrary and unfair rationing in the NHS to end.

Simon Burns: I congratulate the hon. Member for North Tyneside (Mrs Glindon) on securing this debate and the shadow Minister, the hon. Member for Copeland (Mr Reed), for more or less keeping a straight face during the course of it.

Jamie Reed: For the Minister’s delectation, I should say that it is exceptionally hard to keep a straight face when he is in the Chamber.

Simon Burns: I am extremely grateful. I take that as a compliment, because I would hate to reduce the hon. Gentleman to tears.
	As the hon. Lady and other hon. Members well know, cost-based rationing of the sort that she has described is not permitted and not condoned.

Debbie Abrahams: Will the Minister give way?

Simon Burns: No, I will not; I am going to make some progress. This is not the hon. Lady’s debate and I have only just started.
	If the hon. Member for North Tyneside or any other member of her party or of the public brought forth genuine evidence of cost-based rationing—blanket bans on treatment—this Government would act decisively to stamp it out, but the fact is that so far we have been brought no such convincing evidence of that.
	The core principle underpinning the NHS is that it is a comprehensive health service, available to all, free at the point of use and based on need and not ability to pay. That principle is enshrined in the NHS constitution and reaffirmed in the Health and Social Care Act 2012.

Mary Glindon: Does the Minister therefore disagree with all that has been said by the BMA and other professionals about their concerns about the rationing that is taking place? Does he doubt them? Does he think that the thousands of people who have contacted Labour’s health check are not telling the truth?

Simon Burns: It is not a question of not telling the truth. If the hon. Lady waits, I will deal with the NHS health check that she has mentioned. I am not sure whether
	she was here for the earlier debate, so she might not have heard me describe it as being as worthless as the piece of paper that Chamberlain brought back from Munich. In the course of my comments, I will outline why that is.
	As I said, the core principle of the NHS is that it is a comprehensive health service, free at the point of use for all those eligible to use it. That principle remains as true and relevant today as it was when the NHS legislation was passed in 1946 and enacted in July 1948, and it will remain true in the years and decades to come for as long as the three main political parties continue to subscribe to that core belief.
	Before I move on to the specific accusations of rationing that the hon. Lady makes, may I first point out that it is this Government who are protecting NHS budgets and increasing the amount of money available to the NHS by £12.5 billion over the course of this Parliament? It was the right hon. Member for Leigh (Andy Burnham) who described such a commitment as “irresponsible”—a comment that I find particularly bizarre coming from a Labour shadow Health Secretary.
	May I ask what the hon. Lady’s party is doing where it is in control of the NHS? Is it increasing spending, or is it cutting it by 6.5%? The lucky escape of the NHS in England is that it has growing budgets under this Government compared with falling budgets had her party won at the last election. If the hon. Lady, who looks a bit perturbed, does not understand what I am talking about, I can tell her that I am referring to what is happening under a Labour Government in Wales who are cutting the NHS budget—a warning to anyone living in England.
	Of course the financial challenge is a difficult one. On its own, the extra £12.5 billion will not be enough to cover the growing demand for NHS services. It is vital that we get the most value—the very best health outcomes, as we like to say—out of every single penny that taxpayers spend, by cutting out waste and focusing more on prevention. It is true that the hon. Lady’s party recognised this too. When Labour was in office, it established NICE—the National Institute for Health and Clinical Excellence—to help the NHS to improve patient care within the finite resources available to it in order to ensure value for money. Through its world-class commissioning programme, it rewarded commissioners for setting priorities. Furthermore, it first recognised the scale of the £20 billion gap between funding and demand that emerged in 2009. The result was the QIPP agenda—quality, innovation, productivity and prevention—with its focus on improving patient care, increasing innovation and gaining greater accountability.
	Since then, the world has changed. Thanks to the horrendous mess in which the hon. Lady’s Government left the nation’s finances, the NHS faces one of the toughest financial settlements in its history, even with its protected budget. That is one reason why the Health and Social Care Act was so vital. To get the best care for patients during a difficult financial settlement, we needed to put clinicians in control—making the connection between clinical and financial decisions, always putting patients’ interests first, and always looking for value for money.
	In future, local priorities will be determined by local clinicians, not by administrative organisations that lack sufficient clinical input and are cut off from
	patients. Commissioning decisions will be based on a far deeper understanding of local need, with clinical commissioning groups working with health and wellbeing boards, local authorities and key community organisations to meet the needs of their local population. There will be better, more effective, more efficient care for patients.
	Let me address directly the accusations of rationing. We are clear that it is completely unacceptable for commissioners to impose blanket bans on treatments. That is set out in case law and in Department of Health policy, which requires commissioners to allow exceptions in individual circumstances. We are also clear that commissioners must never restrict access to treatments on the basis of cost alone. That message was reiterated in a letter from Professor Sir Bruce Keogh, the NHS medical director, to the medical directors of strategic health authorities as recently as September 2011. He emphasised that any decision to restrict access to a treatment or intervention must be justified by a patient’s individual circumstances. By that, I mean not their financial circumstances, but their clinical circumstances and condition.
	Since then, my ministerial colleagues and I have reiterated the message in our communications with the service that treatments available on the NHS are based on clinical need; that there should never be any arbitrary rationing based on cost, either locally or nationally; and that we will take action against any organisation found to be arbitrarily restricting treatment without clinical justification.
	As hon. Lady said, the Labour party recently made a series of serious accusations in its NHS health check—accusations that services are being restricted or decommissioned without clinical justification. Had the hon. Lady done some rudimentary checking of her own, she would quickly have come to the same conclusion that we did: that such claims are nonsense dreamed up in Labour party headquarters.
	The NHS health check claimed that there was a blanket ban by NHS Hull on the removal of wrist ganglia. We spoke with NHS Hull. There is no such ban. The health check claimed that 11 out of 100 primary care trusts or clinical commissioning groups restricted laser revision surgery for scars, but such cosmetic surgery has never been routinely available on the NHS, either in the lifetime of the coalition Government or in the 13 years of the last Labour Government. The position has not changed one iota since the Government came to power.
	The NHS health check claimed that weight-loss surgery is restricted. It states:
	“patients generally have to be over 18 and have a BMI over a certain level to receive weight loss surgery”.
	Incredibly, people have to be overweight before they will be considered for weight loss surgery. To me, that seems perfectly logical. Why would the NHS want to treat people who were not overweight? From reading the Opposition’s NHS health check, it appears that the Opposition define rationing as a clinician denying treatment to a patient who has no clinical need for it. That is patently ridiculous. Treatments available on the NHS are based on clinical need. As I said, there should never be any arbitrary rationing based on cost, either locally or nationally. Such practices are totally unacceptable.

Julie Hilling: I have listened very carefully to the Minister, who is saying that he does not believe the reports are true. Does he feel, however, that he ought to do more investigation? The BMA’s research and other research makes these points, whereas he simply says he has spoken to one commissioning group. They say that there is no smoke without fire, and it seems to me that the Government ought to take these allegations seriously and investigate properly what is happening.

Simon Burns: Of course the Government take these allegations very seriously, which is why my officials rang NHS Hull to ask about wrist ganglia and were amazed to be told that there were no restrictions as described in the Labour party’s political leaflet. [Interruption.] If the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) will just hush for a minute, I will answer the question. I am always very pleasant to her, as she knows from experience.
	I have personally made checks on two allegations about rationing, one in south-east Essex, south of my constituency, and one that I believe from memory was in Bedfordshire. My officials investigated both claims, which arose out of a meeting that I had with a clinician, and both claims were untrue. There had been a mistaken understanding of what was going on, and there was no rationing based on cost. The conditions in each trust were quite specific, and cases were determined on clinical grounds.
	I also looked into one example after reading a story in my local newspaper about what was allegedly going on in the mid-Essex primary care trust, which is now part of the north Essex cluster. It was to do with the treatment of people suffering from overweight. Again, the story was inaccurate. There was no truth in the allegation that the trust was refusing to treat smokers or people who were overweight. They were treated, providing that it was clinically safe to do so. The three specific allegations that I have investigated, both myself and through my officials, have proved to be untrue.
	As I said earlier, we have had officials look at the Labour party’s political document because, on the face of it, it raised serious allegations that merited investigation. I am afraid that the examples that I have given have not met the reality of the headline claims.

Jamie Reed: I appreciate the confidence that the Minister is showing in refuting the evidence put to him based on freedom of information requests to the PCTs in question. He mentioned three cases out of 125. When will he assess the remaining 122, and will he publish that assessment?

Simon Burns: This debate is half an hour long, and I have been fortunate enough to have 15 minutes. We have investigated all the claims, but it would not be in the interests of the hon. Member for North Tyneside, or possible in the time allowed, for me to go through all of them. I have been assured that the evidence that Labour claimed to have in its party political document does not live up to the hyperbole of the hon. Member for Copeland or the shadow Secretary of State.
	Appropriate, clinically based decisions about the setting of priorities will continue to be taken by commissioners in the NHS. However, by shifting decision making to local clinicians, we will ensure that those decisions are fair, transparent and based on the best clinical evidence. Treatment should never be restricted without clinical
	justification, and I say again that we will take action should any genuine evidence emerge that that is occurring. We regard it as unacceptable as Opposition Members do; the trouble is, the evidence that they have come up with so far does not live up to the claims that they make about it.
	Question put and agreed to.
	House adjourned.